Hey there I had one of my wisdom teeth pulled on the lower left quadrant about 8 days ago and the hole is nearly closed up. However in the past day or so, i have been getting a sharp pain only when drinking cold water. This never happened the whole time i was healing and there is no other pain i am currently feeling. Any idea as to why this could be happening? is it an infection?

Yes, it is likely that when the wisdom tooth was removed that the root of the tooth in front of it could have become exposed as a result of the surgery. An exposed root can cause thermal sensitivity to things such as cold and sweets. It not an infection and should calm down within several weeks...if it does not, consult your dentist. You may need to have the exposed root desensitized with medicaments or laser treatment. Dry sockets can be sensitive to cold but that is not typical as there are other things that present with dry socket such as deep throbby pain, foul odor, and pain no matter what you do but it typically goes away fairly quickly.

Dr.Glasmeier

I received a filling to 2 of my teeth a few hours ago and my tongue still feels numb and is relatively swollen
What can i do to help take down the swelling and the numbness?

Great question..I am assuming you had fillings done on the lower jaw. It is very uncommon to have to numb the entire side of the jaw where the tooth receiving the filling is located. When the jaw is numbed, the following are also numbed: teeth, gums, jaw, tongue, and lips. The tongue is actually a good side that the dentist numbed you adequately.

Depending on the dentist injected you, how many injections they gave you and the tye of anesthetic they gave you, it could could range form 30 minutes to 8 hours. It is unlikely you have swelling and the numbness will subside as your body metabolizes it. I would only be concerned if it lasts longer than 1 day. Time is on your side!

Dr.G

Dr.G, why do you favor IV sedation over oral sedation? Mark S.

Hi Mark,

Great question!! While I like oral sedation and I use it all the time, my biggest concern is patient safety. How many times have you heard of a child, or even an adult for that matter, swallow more pills that they were supposed to. As a result, you have no idea what to predict or how the person react. Some will just make theirself purge or in extreme circumstances have their stomach pumped.

Oral sedation can work well but not necessarily be as predictable in seeing the outcome. Some will barely be sedated, some not all, others will be completely "snowed" over and there are many variables that can determine this: age, height, weight, medical history, male vs female, level of anxiety, etc. Oral sedation works relatively well but I would recommend having your dentist do a test run if you have inadequate results with oral sedation. I, sometimes, will due to a test appointment with the medications with my patient and not do any treatment but more less assess how the patient will respond. Being able to see this helps ascertain what treatment we can do and how much.

Its because of this that I prefer IV sedation, where I have more control over what goes on, and I can reverse the process quickly if I am not happy with how it is going. It tends to be more predictable, faster acting, and ultimately safer. You won't find any oral surgeons who would prefer oral or IV sedation due to the same reasons!

Hope this helps!

Dr.G

How is gum disease(periodontitis) treated?

Treatment Overview

Early treatment of gum disease is very important. The goals of treatment are to prevent gum disease from permanently damaging tissues, control infection, and prevent tooth loss. For treatment to be effective, you will need to:

• Keep your teeth clean by brushing twice a day and flossing once a day.
• See your dentist regularly for checkups and cleanings.
• Avoid all tobacco use. Tobacco decreases your ability to fight infection, interferes with healing, and makes you more likely to have serious gum disease that results in tooth loss.

Treatment for early-stage gum disease

If you have early-stage gum disease (gingivitis), you may be able to reverse the damage to your gums:

• Brush your teeth twice a day, in the morning and before bedtime.
• Floss your teeth once a day.
• Use an antiseptic mouthwash, such as Listerine, or an antiplaque mouthwash.

Your dentist will want to see you for regular checkups and cleanings. Professional cleaning can remove plaque and tartar that brushing and flossing missed. Once you have had gum disease, you may need to see your dentist every 3 or 4 months for follow-up.

Your dentist may prescribe antibiotics to help fight the infection. They can be applied directly on the gums, swallowed as pills or capsules, or swished around in your teeth as mouthwash. Your dentist may also recommend an antibacterial toothpaste that reduces plaque and gingivitis when used regularly.

Treatment for advanced gum disease

Early-stage gum disease (gingivitis) that is not treated promptly or that does not respond to treatment can progress to periodontitis. Periodontitis requires prompt treatment to get rid of the infection and stop damage to the teeth and gums, followed by long-term care to maintain the health of your mouth.

• Your dentist or dental hygienist will remove the plaque and tartar both above and below your gum line. This procedure, called root planing and scaling, makes it harder for plaque to stick to the teeth.
• Your dentist may give you antibiotics to kill bacteria and stop the infection. They may be applied directly on the gums, swallowed as pills or capsules, or inserted into the pockets in your gums.
• You may need surgery if these treatments don't control the infection or if you already have severe damage to your gums or teeth. Surgery options may include:
• • Gingivectomy, which removes and reshapes loose, diseased gum tissue to get rid of the pockets between the teeth and gums where plaque can accumulate.
  • A flap procedure, which cleans the roots of a tooth and repairs bone damage.
  • Extraction, to remove loose or severely damaged teeth.
• After surgery, you may need to take antibiotics or other medicines to aid healing and prevent infection.

After treatment, you will need to keep your mouth disease-free by preventing plaque buildup. You will need to brush carefully and thoroughly after all meals and snacks and floss daily. Your dentist will probably prescribe an antibacterial mouthwash.

Your dentist will schedule follow-up appointments every 3 to 4 months for cleaning and to make sure that the disease has not returned.

Last week my 17 yr. old son went to the dentist and was informed that he has enamel erosion which caused him to have 6 new cavities. The dentist said that the loss of enamel was most likely caused by his braces, which he had removed last year, and that the erosion will continue to spread and get worse. Is enamel erosion common after removal of braces? What should we do?

P.S. Thanks for serving our country!!

Good question and the answer is yes and no. It is very common to see teenageers come out of braces and have cavities that have developed in the process. To describe it as "enamel erosion" is a little ambiguous however. Typically there are 2 common areas to see cavities when a patient has their braces removed:

1. Lip/cheek side surface of the teeth where the brackets were bonded on the teeth.

2. Also occur between the teeth where you normally floss but very difficult when in braces.

Back to your question...erosion and cavities are two different things. I would ask the dentist to clarify what has happened. Erosion can lead to cavities but they are 2 separate situations. There is a chance he will need fillings where the erosion/cavity occurred. I would have him focus on their hygiene and also consider getting on a Fluoride prescription until everything stabilizes. The other question I would ask the dentist would be were any of these present during the past couple recall/cleaning appointments as cavities don't typically occur that quickly unless it had been a while since his last checkup. Hope this helps!

Dr.G