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It’s human nature to delay tackling problems. We even have the clichés to prove it:  “Leave well enough alone.” “Out of sight, out of mind.” “If it’s not broken, don’t fix it!” But when it comes to your health, proactive care is always best. And when it comes to dental health, your wisdom teeth are certainly something to be proactive about!

Children have 20 baby teeth that are replaced over time with 32 adult teeth. The last to arrive, in our late teens and early twenties, are the four third molars, or wisdom teeth. But that “32” total is a little flexible. Some people never develop wisdom teeth at all. You can stop reading here if you are one of this carefree group. The rest of us have from one to four wisdom teeth, and it’s a smart idea to ask our dental professionals just what we have going on below the gumline.

Your dentist might be the first to mention your wisdom teeth at your regular checkup, or you might be surprised to see a new tooth emerging while you are doing your nightly brushing and flossing. Wisdom teeth can remain trapped under gums and bone, a condition called “impaction,” they can erupt partially, or sometimes even erupt completely. They can be symptom-free, or may present with pain, redness, swelling, or bad breath. But whenever the first signs of wisdom teeth appear, in an X-ray or in your mirror, it’s time to discuss your options.

Completely Impacted Tooth

A wisdom tooth may never erupt, remaining trapped below your gums because it has no room to emerge. Even though it isn’t visible, an impacted wisdom tooth can pose serious risks requiring its extraction:

• Other teeth might be pushed out of alignment as the tooth tries to emerge
• The roots of neighboring teeth can be damaged by pressure from the trapped tooth
• A cyst can develop around the impacted tooth which can damage neighboring teeth, nerves, and bone
• Rarely, a tumor can develop. While these are usually benign, they can require the removal of bone and tissue.

Even if you are symptom-free, regular exams and X-rays are important for monitoring the condition of impacted wisdom teeth to make sure that they remain problem-free.

Partially Impacted Tooth

A wisdom tooth can also begin to erupt, but never break completely through the gums. The partially exposed tooth and the gum tissue are very difficult to clean effectively, trapping food particles and bacteria. Partially erupted teeth:

• Have a greater chance of serious decay
• Increase the risk of gum disease
• Can also cause problems as they emerge when they are angled toward neighboring teeth.

When infection and rapid decay are present, or the tooth is emerging at an angle which can damage nearby teeth or bone, extraction is often considered the best treatment option.

Preventive Extraction

Some people have enough room in their mouths to accommodate wisdom teeth without affecting the alignment of their other teeth or their bite. Some wisdom teeth never erupt at all, staying within the jawbone without affecting other teeth. If there are no problems with these teeth, your dentist and oral surgeon might recommend leaving them in place and monitoring them carefully.

If there is the potential for crowding, damage to nearby teeth, or any other future problems, extraction could be recommended as a preventative measure. Age can be an important factor in recommending extraction as well. Patients in their late teens and early twenties often have an easier time with wisdom tooth surgery because:

• The roots of the wisdom tooth aren’t as developed
• Jawbone structure is not as dense
• Shorter roots aren’t as likely to impact sinuses in the upper jaw
• Shorter roots are less likely to cause interference with nerves in the lower jaw
• Bone healing and regeneration is more efficient at this age.

If you are considering the best plan of action for your wisdom teeth, an appointment with Dr. Mazock, Dr. Salazar, and Dr. Coleman at our San Antonio or Castroville office is a very good idea. Oral and maxillofacial surgeons have a minimum of four years of advanced studies in a hospital-based residency program, where they train with medical residents in the fields of general surgery, anesthesiology, internal medicine, and other specialties with a specific focus on the bones, muscles, and nerves of the face, mouth, and jaw.

Oral surgeons like Dr. Mazock, Dr. Salazar, and Dr. Coleman are experts in dealing with wisdom teeth and surgical extractions. And while most extractions are fairly straightforward, their surgical training and experience is invaluable where extractions are more complicated due to the position of the tooth in the jaw, the degree of impaction, and the length and development of the roots. They are trained in all forms of anesthesia, and can provide whichever method you choose for your most comfortable experience, whether it be local anesthesia, sedation, or general anesthesia.

When you’re dealing with your health, the only cliché that really applies is “An ounce of prevention is worth a pound of cure”! Whether your wisdom teeth are best treated with extraction or regular monitoring, Dr. Mazock, Dr. Salazar, and Dr. Coleman can help you decide on the best plan for your dental health both today and for your future.

What is a dentist?

Dentistry has been around for hundreds and possibly thousands of years. Tools and depictions of procedures using those tools have been discovered among many different early civilizations throughout history. The field of dentistry became solidly mainstream in the 1800s when “dentists” organized their practice as a primary professional activity, rather than as one of an array of services.

Modern dentists require a medical license that is awarded after completion of a number of years of rigorous schooling. These medical professionals are taught to address the maintenance of healthy teeth and gums, though some obtain additional licenses that focus on more specific areas of oral health.

General dentistry is usually sought for cleaning and mending of slightly damaged teeth, while providing advice on future prevention of decay and other problems. As society has seen a dramatic shift in the cosmetic direction, many dental professionals have trained to offer whitening procedures as well.

Where does an oral surgeon come in?

Patients are often referred to an oral-maxillofacial surgeon if a procedure exceeds the abilities of a general dentist. While dentists are often capable of handling simple extractions, teeth that have become severely impacted usually require someone with greater expertise. In many cases, the patient will be put under sedation for the duration of the more complex procedure, and may require several days for sufficient healing.

In addition to more difficult extractions, oral surgeons commonly handle:

• Implant surgery
• Reconstructive surgery on the jaw or face to resolve problems with speech and proper function
• Corrective surgery of the jaw to improve structure and alignment
• Grafting of the bone or soft tissues in order to resolve defects and injuries
• Repair of birth defects that have affected the face or jaw

Which medical professional should you see?

Teeth are extremely important and should be treated with care. As the surface of a tooth wears down, more sensitive tissues can become exposed, and in cases where decay is allowed to continue, even the nerve can be affected.

When it comes to identifying which of these practitioners you should see, a consultation is almost always necessary if you have special concerns. Seeing Dr. Mazock, Dr. Salazar, and Dr. Coleman on a regular basis is highly recommended, but many clients fail to do so until they begin to experience pain or discomfort. If you are diligent in receiving routine care, though, you are more likely to prevent problems that will require the services of an oral surgeon, and will probably be happier with your smile in general.

By now, everyone knows that smoking is bad for you. But the truth is its broad-reaching health effects are not all known by everyone. This is especially true of oral health. Smoking can have serious repercussions in this regard. To give you a better idea of how smoking can affect your oral health, Dr. Mazock, Dr. Salazar, and Dr. Coleman and our team have listed some issues that can arise.

Oral Cancer

Oral cancer can have steep ramifications for anyone that gets it. Surgery can be required to eliminate the cancer before it spreads to more vital parts of your body. Any type of cancer is about the worst health effect you can get, and this especially holds true to the affects that smoking has on your mouth. The type of mouth surgery required with oral cancer can leave your face deconstructed in certain areas, and it is all due to smoking or use of other tobacco products.

Tooth Discoloration and Bad Breath

At the very least, it is fair to say that as a smoker you will often have bad breath, and while you may try to cover it up with gum or mints, tooth discoloration is a whole other story. The chemicals and substances in cigarettes stick to your teeth staining them brown and yellow colors that are increasingly difficult to disguise.

Gum Disease and Loss of Bone

Another effect of smoking is the increased risk of gum disease. Your gums may start to recede, which can eventually lead to the loss of teeth. Smoking can also increase bone loss and density in your jaw which is vital to the health of your mouth. Gum disease and bone loss are two signs that smoking is definitely bad for your mouth.

When it comes to the health of your mouth, the question is not whether smoking affects your health, it's how does it affect your health and to what degree. If for no other reason than because smoking involves your mouth as its entry point, it is safe to say that it can have long-lasting and detrimental consequences on your oral health.

To learn more about smoking and your oral health, contact our San Antonio or Castroville office to schedule an appointment with Dr. Mazock, Dr. Salazar, and Dr. Coleman.

When your wisdom teeth start to emerge it can definitely be painful, but it can be even worse if your wisdom teeth become impacted. Impacted wisdom teeth are trying to erupt but are unable to do so because there is not sufficient room for them to emerge. This usually means that your wisdom teeth are painfully lodged in your jawbone.

While you may not see any real signs of the emerging wisdom teeth when they are impacted, what you can’t see can still definitely hurt you. Some of the indicators of impacted wisdom teeth are listed below.

• Jaw Pain: Pain in the back of your jaw is a common indicator of impacted wisdom teeth. The pain often concentrates in the area around your gums.
• Changes in the Mouth: You may notice some changes in your mouth when you have impacted wisdom teeth. Reddish gums, swelling in the jaw, bleeding gums, and bad breath can all be indicators that you are dealing with impacted wisdom teeth.
• Headaches: If you suddenly start having headaches, especially at the same time as some of the other issues mentioned above, they may indicate impacted wisdom teeth.
• Chewing Issues: Problems with chewing normally can indicate impacted wisdom teeth. If you are having trouble making the chewing motions because your mouth won’t quite open and close as easily as it used to, impacted wisdom teeth may be the culprit.

The Solution

If you are suffering from impacted wisdom teeth, the best solution is usually going to be removal. This is not a problem that will resolve naturally, and in fact, your pain and other symptoms may worsen as your wisdom teeth become increasingly impacted. At San Antonio Oral & Maxillofacial Surgery Associates, P.A., Dr. Mazock, Dr. Salazar, and Dr. Coleman can review the details of wisdom teeth removal surgery with you and help you determine if this is the best solution for your situation.