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You may have heard this term the first time you or a friend got your wisdom teeth. That makes sense, as wisdom teeth are the teeth most often impacted in teenagers and young adults. But other permanent teeth can be impacted as well. What exactly do we mean by “impacted teeth,” and what can we do to treat them?

The term “impacted” means that somehow a tooth has been blocked from erupting properly. A tooth may be completely blocked by another tooth, erupt in the wrong space, or even come in from the wrong direction. Depending on the teeth involved, there are several different options for treatment.

From Baby Teeth to Permanent Teeth

Normally, when children lose a baby tooth, a permanent tooth is right there, ready to take its place. But teeth don’t always behave according to plan. Occasionally, that baby tooth just won’t budge, and the permanent tooth starts to erupt behind it. When this happens, a simple baby tooth extraction will often let the permanent tooth move into its proper position on schedule.

A more complicated situation develops when upper teeth are impacted because there isn’t enough space in the mouth for them. In this case, a device called a palatal expander might be used to gradually widen the upper jaw to allow the permanent teeth to erupt without crowding.

In other rare cases, a tooth (often the canine) fails to erupt and may require oral surgery to uncover it, followed by orthodontic treatment to guide it into position.

Impacted teeth can result from other causes as well, and every impacted tooth should be treated as quickly as possible. Left untreated, the teeth can fail to erupt at all or erupt in the wrong place, crowd other permanent teeth, damage the roots of the teeth near them, and lead to difficulties eating and dental pain.

Wisdom teeth

Wisdom teeth are often a problem because there is simply not enough room in the jaw for them.

Wisdom teeth that are completely impacted (still in the jawbone) can sometimes be left alone if they aren’t causing other problems. But if impacted wisdom teeth develop cysts, affect the teeth around them, or lead to other dental complications, they should be extracted.

Partially erupted teeth, those that have begun to emerge through the gums but don’t erupt fully, can be the source of different gum and tooth problems. Because the gum tissue overlaps the tooth, food particles and bacteria can become trapped, leading to rapid tooth decay and even infection. In this case, extraction is probably the best option.

Be Proactive

The term “impacted” actually comes from the Latin root meaning “pushed against.” But teeth that don’t erupt at the right time, in the right place, can have a different kind of impact on dental health and appearance. And the earlier we can catch these problems, the easier it is to treat them.

Regular exams and X-rays with Dr. Chad Vanourny at our Charlotte office will show the progress of the teeth even before they erupt, and if there will be the space for them to fit in the mouth properly. We may recommend a visit to the orthodontist by the age of seven to see if there are any signs of potential orthodontic problems.

Intervention at an early stage can prevent potential problems from becoming major ones. That is why it’s so important to be proactive when teeth are erupting in children and young adults. After all, a healthy, confident smile makes a real impact!

We’re used to seeing athletes wearing mouthguards at practice or play, because dental trauma is one of the most common (and predictable) sports injuries. But it’s not just athletes who are at risk, and there are some events in our daily lives that we just can’t predict. Car accidents, falls, workplace injuries, even innocent playground structures can take their toll on our smiles.

A major chip or a crack in your tooth is upsetting enough, and should be seen by Dr. Chad Vanourny as soon as possible. It’s even more unnerving when a tooth is knocked out completely. The technical term for a tooth which has been knocked out is an avulsed tooth, and it is a true dental emergency.

If you should suffer a partially or completely dislodged tooth, there is a possibility that your tooth can be reimplanted—if the damage isn’t too severe and if you get to our office immediately.

How can a lost tooth be saved? This is possible because of the complex biological engineering that anchors our teeth within the jaw. The root of a tooth is surrounded by the periodontal ligament. This connective tissue attaches the tooth to the alveolar bone of the jaw. When a tooth is knocked out, this ligament splits apart, leaving some tissue on the tooth root and some within the tooth’s socket.

To successfully reimplant a tooth, the connective tissue cells around the root of the tooth need to be vital, so that they can begin to reattach to the connective tissue left in the socket. Over time, this reattachment is complete, and the tooth becomes firmly anchored to the bone again.

It’s important to protect your tooth before you see Dr. Chad Vanourny to make sure there will be enough healthy tissue for reattachment. First of all,

• Don’t panic! If you or a friend or family member lose a tooth, call your dentist or your emergency health care provider as soon as possible. You will get specific instructions for your specific situation.

If you are unable to reach a healthcare provider immediately, there are some general rules for taking care of an avulsed tooth:

• Find the lost tooth. Don’t touch the root—use the crown, or top part of the tooth, to pick it up. You are trying to preserve and protect the connective tissue on the root surface.

• If the tooth is dirty, gently rinse it in milk, saliva, or water. Don’t wipe it off, though. You could damage those connective tissue cells mentioned above.

• Place the tooth back in the socket, if possible. Gently hold it in place with your fingers or bite down (again, gently). You can also place the tooth in your mouth next to your cheek.

• If returning the tooth to the socket is not an option, or if you are worried about a child possibly swallowing the tooth, keep the tooth moist. Whole milk or solutions sold just for the purpose of preserving an avulsed tooth are better choices than water, which damage the tissue cells on the root. And never wrap the tooth tightly—this can also damage the connective tissue.

Above all,

• Don’t delay! The faster a tooth is reimplanted in its socket, the greater chance you have of keeping it. Really, every minute counts. Reimplantations are more successful if they take place within 30 minutes. After an hour out of the mouth, your tooth’s chances of successful reintegration are lower—but still worth pursuing!

What will Dr. Chad Vanourny do?

• Evaluate the avulsed tooth.

There are variables which can affect whether or not a lost tooth is a good candidate for reimplantation. Trying to replace a baby tooth, for example, could interfere with the formation of the adult tooth. An adult tooth that is broken will probably require a different type of treatment.

• Prevent infection.

You might be given antibiotics and a referral to your medical doctor for a tetanus booster if needed.

• Clean the site.

The socket will be gently irrigated to clean the area and to remove any clots that may have formed which can interfere with the tooth’s placement.

• Recommend or perform a root canal.

Nerves and blood vessels within the tooth’s pulp generally don’t recover after a serious traumatic injury, so a root canal procedure could be necessary to preserve the health of your tooth. This procedure might be done immediately, or might be recommended for a later date.

• Stabilize your tooth.

The tooth must be stabilized after being reimplanted, so Dr. Chad Vanourny will use a splint to anchor the tooth to the teeth next to it. The splint can be flexible or rigid, depending on the condition of the alveolar bone. Splinting generally takes from two to eight weeks, and you will be given detailed instructions for taking care of the area while you heal.

Losing a tooth is an alarming experience. But with prompt action, and a trip to our Charlotte office, it might be possible to make that loss only a temporary one.

Scientists have discovered tooth decay in specimens that are more than 15,000 years old. The ancients once thought that cavities were caused by something called “tooth worms” … Eew! They didn’t exist, of course, but how else could humans explain the holes that cavities make in teeth?

The appearance of cavities on a widespread basis is often traced to the rise of farming. The new diet filled with grains and carbs made our mouths a haven for cavity-causing bacteria. As we added more sugar to our diets, our teeth got worse.

The “tooth worm” idea didn’t completely disappear until the 1700s when scientists finally began to understand the process of dental caries. Once that part of the puzzle was solved, they began focusing on filling existing cavities and preventing new ones.

Dental Fillings Come of Age

Many different materials, including beeswax, cork, aluminum, tin, and even asbestos, have been used to fill the holes caused by dental decay. Sometime in the mid-1800s, however, dentists began to use metal fillings such as gold, platinum, silver and lead amalgams.

The amalgam we use today is mixed from liquid mercury, silver, tin, copper, zinc, and other metals, but some patients still like the look of a gold filling. Newer options include composite-resin fillings, which are made from a tooth-colored mixture of plastic resin and finely ground glass-like or quartz particles that form a durable and discreet filling. Porcelain or ceramic fillings are natural in color, but more resistant to staining.

Dr. Chad Vanourny can help decide which filling is best for you, based on cost as well as your dental and lifestyle needs. You may not have “tooth worms,” but if you have cavities, contact our Charlotte office so we can take the proper action to protect the health of your mouth.

Rumor has it that the Queen of England doesn’t allow garlic in the palace. And, even if you have no royal duties in the near future, it might be a good idea to avoid foods like garlic and onion before a big presentation or a first date. But if your diet is filled with mint, fresh apples, and parsley and you still worry about your breath, here are some common causes for bad breath that you might not have considered.

• A Slip of the Tongue

We brush and floss to remove food particles and bacteria. After all, bacteria that linger in the mouth produce acids that damage tooth enamel and cause bad breath. But there is one important brushing target you might be overlooking—your tongue.

Remove food particles and bacteria on the surface of the tongue with a gentle brushing after you have finished cleaning your teeth. With a dab of toothpaste, brush the top of your tongue gently from back to front. There are also tools called tongue scrapers available that are specifically designed to remove food particles and bacteria from the tongue’s surface. However you choose to clean your tongue, remember to move from the back to the front, and always clean gently.

• A Dry Spell

We spend the vast majority of our day not brushing our teeth. What helps keep breath fresh even during the hours between brushings? Saliva! As saliva bathes the teeth throughout the day, it not only washes away food particles and bacteria, but also neutralizes the enamel-damaging acids that are produced by bacteria. Yet another benefit? Saliva is not a friendly environment for the oral bacteria that produce volatile sulfur compounds (VSCs). It is these compounds that cause most of the unpleasant odors we know as bad breath.

If you are drinking the recommended amount of water each day, you are helping your body produce saliva and fight bad breath. Sometimes, a medical condition called dry mouth, or xerostomia, interferes with saliva production. Talk to Dr. Chad Vanourny about ways to deal with dry mouth. Solutions as simple as drinking more fluids or chewing sugarless gum can help, or we can suggest over-the-counter products or prescription medications if needed.

• A Bad Night’s Sleep

We’re all familiar with the concept of morning breath. As we sleep, our saliva production naturally decreases. It’s like a nightly version of dry mouth. Without normal levels of saliva, bacterial growth takes off, VSC’s are produced in greater quantities, and we wake up wondering what on earth happened to that fresh feeling we had after brushing the night before.

Unfortunately for snorers, nighttime brings more problems. Snoring leads to mouth breathing, and mouth breathing creates an even drier environment where oral bacteria increase more quickly. If you find you are consistently waking up with an especially unpleasant case of morning breath, you could be a chronic snorer without even realizing it. If you discover or suspect you have a snoring problem, talk to Dr. Chad Vanourny or your GP. Snoring can have serious health consequences, so let’s discuss possible solutions.

One important note to end on: if you have eliminated all the obvious causes of halitosis but still have persistent bad breath, give our Charlotte office a call. Chronic bad breath can be a symptom of serious gum disease, oral infections, illnesses such as diabetes or kidney disease, and other medical conditions that should be treated as soon as possible. If the topic is bad breath, let’s make sure garlic is the only thing you have to worry about.