Teeth damaged by decay, periodontal (gum) disease or trauma are often removed (extracted) if they’re deemed beyond repair. But there’s another reason we may recommend an extraction: a tooth is causing or has the potential to cause problems for other teeth and your overall oral health.
Some of the most frequent cases of “preventive extraction” involve the third molars, or wisdom teeth, located in the very back of the mouth. They’re usually the last permanent teeth to come in, which is related to some of the problems they can cause. Because they’re trying to come in among teeth that have already erupted they don’t always erupt properly, often at abnormal angles or not fully erupting through the gums, a condition called impaction.
Impacted or misaligned wisdom teeth can put pressure on adjacent teeth and their roots, which can cause root resorption that damages the second molar. They can also increase the risk of periodontal (gum) disease in the gum tissues of the second molars, which if untreated can ultimately cause teeth and bone loss.
Because of current or possible future problems with wisdom teeth, we often consider removing them at some early point in the person’s dental development. Such a consideration shouldn’t be undertaken lightly, since wisdom teeth extraction is often complex and fraught with complications, and it usually requires a surgical procedure.
That’s why we first conduct a comprehensive examination (including x-ray or other imaging to determine exact location and possible complications) before we recommend an extraction. If after careful analysis an extraction appears to be the best course, we must then consider other factors like planned orthodontics to determine the best time for the procedure.
Once performed, a wisdom tooth extraction can resolve existing problems now and reduce the risks of gum disease or malocclusions in the future. When it comes to wisdom teeth, removing them may be in your or your family member’s best interest for optimal dental health.
If you would like more information on wisdom teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Wisdom Teeth.”
Dental work isn’t performed in a vacuum — the state of your general health can have an impact on procedures and vice-versa. This is especially true if you’re taking certain medications like blood thinners.
Blood thinners such as Warfarin or Clopidogrel are used for a number of medical conditions as an anti-coagulant (inhibiting blood from clotting). They’re commonly part of a stroke or heart attack prevention strategy in patients with cardiovascular disease, or those with tendencies for thrombosis (blood clot formation within blood vessels) or pulmonary embolisms (blood clots within the lungs). They’re also used with patients with artificial heart valves or on a temporary basis with patients who’ve recently undergone knee replacement or similar surgical procedures.
In most cases, dental work won’t be affected by your use of a blood thinner. An issue might arise, however, if an invasive procedure has the potential to cause bleeding, like a tooth extraction or gum surgery. Because the blood doesn’t clot normally it may be difficult to stop the bleeding during such procedures.
To avoid undue complications, it’s always best to let your dentist or oral surgeon know what medications you’re taking, especially blood thinners (this includes low-dose aspirin, a common over-the-counter drug that’s often prescribed as a mild blood thinner). Depending on the procedure and your dosage, they may consult with your prescribing doctor to see if temporarily stopping the medication or reducing the dosage is an acceptable precautionary measure for your dental treatment. Your dentist may also take precautions during the procedure to help reduce bleeding such as using haemostatic agents around the wound site to help stabilize blood clotting, while carefully suturing the wound to avoid disrupting smaller blood vessels (capillaries) that easily bleed.
If your dosage has been temporarily stopped or reduced, you’ll usually be able to resume blood thinners immediately after the dental procedure. Working together, your dentist and doctor will help ensure that your health won’t be at risk and your dental procedure will occur without undue complications.
If you would like more information on dental work precautions with medications, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Oral Surgery & Blood Thinners.”