Impacted Wisdom Tooth - Surgically Removal

This is a case report of a surgically removal of the impacted wisdom teeth done in our office today.  The patient is an 18 years old Asian healthy female.

 

 Panorex shows partially impacted wisdom tooth on low right and left jaw. Plan was to remove the wisdom tooth on the lower right side under local anesthesia. Softdental - Minh Nguyen, D.D.S.

Oral exam shows the tip of the right wisdom tooth erupted, the rest of the tooth still submerged under the gum. Softdental - Minh Nguyen, D.D.S.


 

 After the area was anesthetized, the incision was made on the area of the wisdom tooth (#32) and the molar tooth in front of it (#31). Softdental - Minh Nguyen, D.D.S.

Full thickness periosteal flap was raised and the wisdom tooth was dissected and visualized.

Softdental - Minh Nguyen, D.D.S.

The wisdom tooth was elevated with an extraction elevator through the incision out to the oral cavity. Softdental - Minh Nguyen, D.D.S.

The wisdom tooth was surgically removed and inspected. Softdental - Minh Nguyen, D.D.S.

The remain extraction socket of the wisdom tooth, showing minimal bleeding. Softdental

- Minh Nguyen, D.D.S.

The surgical flap was closed with 2 dissolvable stitches (chromic gut suture). Softdental

- Minh Nguyen, D.D.S.

Patient tolerated procedure well, no complication noted for this wisdom tooth surgery. We will follow her up in one week. Softdental - Minh Nguyen, D.D.S.


Her prescription:

1. Decadron 4mg x2 tabbles right away in office
2. Amoxil 250mg one three times a day x 30
3. Vicodin ES one every 6 hours as needed for pain x 30

Houston dentist
Minh Nguyen, D.D.S.

Your Child's Teething

Yesterday my wife asked me,"a friend of mine, her child is having a problem with growing a new tooth.  Both of them could not sleep well. Is there anything that she can do to help her baby?"

Since this is one of the most common dental questions, I think it is best for me to write down my recommendation in this blog, so that the information can be shared to all mothers when needed.

Teething is the process by which a baby tooth erupts (or cuts through) the gum.  It usually occurs between 6 to 24 months of ages.  As the tooth is coming from beneath the surface of the gum, the area may appear slightly red or swollen.  Sometimes a fluid-filled blister similar to a bruise may be seen over the erupting tooth.  The surrounding teeth may also feel more tender.

Common signs and symptoms of teeth include irritability, tender and swollen gum, increased drooling, restless, not sleeping well, refusal of food, and sucking fingers (perhaps.. because he or she is trying to reduce the discomfort in the mouth).

What can you do to help your child?

First, you need to make sure that your child does not have a flu or bacterial infection (like ear infection).  Normally with teething, your child's symptoms should not have fever, cough, and diarrhea.  If your child have any of the "cold" symptoms, it is best to take your child to see the doctor right away.

Second, you can use:

1. Oral over-the-counter pain relievers like children Tylenol or Motrin
2. Topical lidocaine gel (Note that topical medication containing bezocaine may have severe side effect and should not be used to treat teething problem)

Finally, your child's teething problem should be naturally resolved within a few days.  If the problem continues for more than one week, or if the problem is getting worse, then your child may need to be evaluated by your dentist.   Often a quick surgical procedure can be performed in the dental office to assist with the tooth eruption.

Houston dentist
Minh Nguyen, D.D.S.

Smile Transformations Give Mother Nature a Hand

The bad news is that a cleft palate is one of the most common birth defects. The good news is that it usually treatable, with most of the major correction done before a child is out of diapers.

However, many patients require corrective surgical procedures throughout their adult lives to try to give them a pleasing smile.

In the past, our options were limited, but today we have a better understanding of how the skull and facial bones grow, new technologies (including soft and hard tissue lasers), and new dental appliances and treatments that are providing beautiful results.


Correcting a facial deformity requires surgery. However, without performing major surgical procedures to move boney structures, we can use bonding (tooth-colored material that is layered over a tooth and sculpted to mimic a natural tooth), all-porcelain crowns and gum contouring to create a beautiful smile. [We chose not to include "before" photos because of their disturbing nature].

Building up the teeth can help correct a malocclusion (bad bite when teeth don't match up) and provide lip support to make the lip area appear full and even.

A soft tissue laser can be used to contour uneven or overgrown, unsightly gum tissue.

Finally, frequent professional dental cleaning can remove built up plaque that irritates gum tissue and starts the infection process.

If you want to improve your smile, we can discuss your options with you and create a treatment plan to give you a beautiful smile.

Houston dentist
Minh Nguyen, D.D.S.

Seal the Deal on Decay

There are about 4 million children in the U.S who have difficulty sleeping, eating and learning because of caries (tooth decay). Caries is the number one, chronic childhood disease, and it is preventable. One simple way to prevent caries is applying sealant to the top surface of your child's permanent molars where the majority of cavities start.

It is especially important for us to examine your child’s first permanent molars when they erupt (about 6 years old). Permanent molars are susceptible to decay because the top surface is not smooth. There are cusps (bulges at each corner of the tooth), and pits and fissures between the bulges where bacteria and food particles can lodge. The bristles of your child's toothbrush often cannot dislodge all the food debris out of those deep crevices.

Bacteria feed on the lodged food particles and produce an acid that leeches calcium and phosphorous out of tooth enamel. This results in a soft spot on the tooth. If left alone, this spot eventually becomes a cavity.
We can prevent tooth decay with a resin material called a sealant. Sealant is brushed over the top of the pits and fissures. It quickly dries to form a hard, impenetrable surface. If placed in time, a soft spot rarely progresses to a cavity.
Statistics show that caries are reduced by 87 percent the first year the sealant is applied.

Sealant eventually wears down and must be reapplied about every four to five years.
It's important to remember that sealant is not a substitute for daily brushing, flossing, a tooth-friendly diet and regular dental examinations.

A sealant isn't just for kids; adolescents and adults can benefit from it, too!

Houston dentist
Minh Nguyen, D.D.S.

CSI: Dental Crime Stoppers

Crime-time TV shows have introduced a new term to the American lexicon: petechial hemorrhaging. This happens when blood vessels burst leaving tiny, flat, round, red or purple bruises where blood has pooled in the tissue. They don't blanch or fade color when pressed.

On TV, it's evidence an evil-doer strangled the hapless victim. Closer to home, you can see it on your arm where your bratty brother gave you an Indian burn, or in your own mouth. Your own mouth? Let’s examine the evidence.

The most common cause of petechiae is trauma. For example, chewing on a pencil or toothbrush ruptures blood vessels when you push the object against the roof of your mouth. Petechiae can also form if you eat rough, hard foods like chips or crackers. An ill-fitting denture or a jagged, rough filling can cause tiny blood vessels to break.


Petechiae can also be caused by blood disorders, systemic diseases and vitamin C deficiency, and the mouth is often the first place a disease appears.

If the petechiae are caused by a trauma like eating crackers, the bruises usually go away without treatment in a few days. However, an area that is continually traumatized from a habit like chewing pencils or an intentional injury jeopardizes your health.

If you notice anything unusual in your mouth, it is best to let us take a look to rule out a serious condition that needs treatment. Catching a condition in its early stage can be key to your good health, just like catching the butler in the library with the rope right before the credits roll.


Houston dentist
Minh Nguyen, D.D.S.

Kids with cancer - How to Protect Their Teeth

When a child is diagnosed with cancer, everyone's life turns upside down. As your dental care professionals, we can help with your child's dental needs while he or she is undergoing treatments.

We need to begin an oral care program two weeks before your child starts cancer treatments because there are several procedures we cannot perform if your child has already begun radiation or chemotherapy.


We can identify and take care of most existing dental needs so your child's cancer treatment won't be delayed. For example, if your child has an oral infection, cancer treatments will be postponed.


If your child wears braces or a retainer, we need to examine it. An ill-fitting appliance can damage soft oral tissues and provide bacteria an opportunity to cause a gum infection. We can provide you with information about the daily care of an orthodontic device.

Your child needs to maintain a consistent, rigorous daily oral care routine. Start by using xylitol products as soon as possible before treatments begin. Using xylitol five or more times a day will help build a healthier grouping of bacteria in the mouth. Stock up on toothbrushes, too. Switching to a new one about three days after a chemo treatment will provide less contamination when the white blood cell count goes down and your child is least resistant to infection. And come visit us often. The best time is just before a chemo treatment when we can apply fluoride varnish or send fluoride trays home with you to help prepare the teeth for their difficult journey.

We can recommend minor dietary changes to eliminate or minimize foods and supplements that can cause tooth decay.

You can be confident that your child will receive excellent professional medical and dental care before, during and after cancer treatments.


Houston dentist
Minh Nguyen, D.D.S.

Diabetics: Hold the Mayo

There are over 24 million diabetics in the U.S., and another 57 million are teetering on the edge. Diabetics are at risk for developing or worsening their periodontitis (perio), a chronic dental inflammation that prevents their bodies from controlling their blood sugar levels.

Periodontitis destroys a tooth's surrounding support structures and can result in irreversible jawbone and tooth loss [X-ray shows healthy bone level vs jawbone bone loss]. We cannot yet cure perio; we can only manage it.

Like perio, diabetes is an inflammatory disease.

Over 80 percent of diabetics who have perio also show signs of developing heart disease and strokes, which are also inflammatory diseases. The oral infection uses your bloodstream to travel to other parts of your body.


Research is showing that type 2 diabetes and perio are locked into a relationship in which a poorly controlled diet provides sugars and carbohydrates to the bacteria associated with perio. When the inflammation in your mouth becomes more severe, your body overreacts to the acids produced by the bacteria. The chemicals produced by perio make your body more resistant to insulin and keep your blood sugar levels out of balance.

A healthy diet and good oral care can help break you out of that vicious cycle.

As you work with your physician to eat a healthy diet, we will help restore your dental health by treating your perio and regularly monitoring your progress.


Houston dentist
Minh Nguyen, D.D.S.