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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. Varble, Dr. Dill, Dr. Wong, and Dr. Parks at our Creve Coeur or St. Charles 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!

Is this a trick question? After all, you and your family probably already know quite a lot about cavities:

• It all begins when bacteria-filled plaque sticks to teeth and starts to attack enamel. How?
• Because the bacteria in plaque use the sugars and other foods we eat to produce acids.
• These acids gradually weaken teeth by dissolving minerals that help make up our enamel (a process called demineralization).
• Over time, a hole, or cavity, develops in the tooth surface.
• Left untreated, bacterial decay can spread to the inside of the tooth, creating a more serious cavity.

Dr. Varble, Dr. Dill, Dr. Wong, and Dr. Parks might discover an unexpected cavity at a regularly scheduled dental exam at our Creve Coeur or St. Charles office, but there are also some symptoms that should have you calling for an appointment. A cavity can cause sensitivity when eating something hot or cold, or it can be painful, or you might even notice visible discoloration or damage to the tooth surface.

So, if your child has any of these symptoms, it’s a cavity, right? It might be—but it might not. Sometimes, because the symptoms are similar, what we suspect is a cavity is really enamel erosion.

The bacteria-created acids weaken enamel. But it’s not just bacteria that subject our teeth to acids. Acidic foods are one of the leading causes of tooth erosion.

And while we expect damage from a lifetime of acidic foods and beverages to catch up with us as we age, the fact is that erosion is becoming a problem even for young children. How is this possible? Let’s look at some food chemistry.

Our normal saliva pH level is around a 7, which is neutral. Any number lower is acidic; any number higher is alkaline. Acidic foods have a low pH (the pH of lemon juice, for example, measures between 2 and 3), and can reduce our normal, neutral pH level. When saliva pH levels drop to 5.5 or lower, tooth enamel starts to demineralize, just as it does when exposed to the acids from oral bacteria.

Regularly snacking on citrus and other acidic fruits, fruit juices, flavored drinks, sour candies, and other acidic foods can cause enamel erosion. Especially erosive are sports drinks, energy drinks, and colas, because they contain some combination of citric acid, phosphoric acid and/or carbonation.

So, when might you suspect enamel erosion? Your child might be sensitive to hot or cold foods, or feel pain, or even have noticeable enamel loss or pitting. Even though these symptoms may not have been caused by plaque and bacteria, acidic erosion from our diets leaves weakened enamel just as vulnerable to cavities and decay.

How to avoid erosion?

• Serve acidic foods sparingly, or as part of a meal. This helps our saliva pH stay in the neutral zone.
• Balance acidic foods with low-acid choices to neutralize acids and restore a normal pH balance. For example, mix those acidic berries with a banana.
• Use a straw! These are not only fun, but this simple solution keeps erosive drinks from bathing young teeth in acids.
• Encourage your child to drink water instead of an acidic beverage, or drink it afterward to rinse acids away. The pH of pure water? A perfect, neutral 7. And by using tap water instead of bottled water, you’ll be providing fluoride, which helps strengthen enamel.
• What about brushing right after eating or drinking something acidic? Ask Dr. Varble, Dr. Dill, Dr. Wong, and Dr. Parks if your child should rush for the brush. We may recommend waiting 30 minutes or so after an acidic treat to give the teeth time to remineralize. Otherwise, brushing might cause more wear and tear on enamel.
• Finally, while foods are often the source of acid erosion, medical conditions can cause erosion as well. Talk to us about ways to minimize erosion while addressing these medical needs.

Be proactive. Ask your Dr. Varble, Dr. Dill, Dr. Wong, and Dr. Parks about healthy drinks and snacks for healthy teeth. Make sure to keep on top of brushing and flossing, and stick with fluoride toothpastes. And visit our Creve Coeur or St. Charles office regularly for exams and cleanings.

There’s really no trick to it—preventing enamel erosion helps keep your child’s teeth structurally strong and cavity-free for a lifetime of beautiful and healthy adult smiles.

When you were younger, and you brushed your teeth without any help for the first time, it was a big step. It meant you’d learned the right way to brush to keep your teeth and gums healthy. But why does brushing help keep you healthy? Let’s talk about plaque!

• What Is Plaque?

Plaque rhymes with “attack,” and that’s just what it does to your teeth. If you don’t brush for a few days (which is a bad idea!), plaque is the reason for that fuzziness you feel when you run your tongue over your teeth.

If your teeth feel fuzzy, that means that plaque has been building up for a while. But how does it begin?

Plaque is made up of saliva, bits of food, other liquids, and tiny little organisms called bacteria. While most of the bacteria in our bodies don’t bother us—and some even help us—the bacteria in plaque are not so helpful.

Plaque starts with a type of bacteria that stick to the teeth, loosely at first, and then more strongly. Within hours, they join with saliva, bits of food, and other bacteria and bacterial products to make a very sticky film. This film is plaque.

Why is it so important to brush plaque away every day? As Dr. Varble, Dr. Dill, Dr. Wong, and Dr. Parks will tell you, plaque can cause cavities and hurt your gums.

• How Does Plaque Cause Cavities?

Bacteria are like us—they need food. The bacteria in plaque especially like the sugars we eat. (That’s why you shouldn’t have too much junk food or candy in your diet.) Bacteria change these sugary building blocks into a kind of acid, and because plaque is sticky, the acids stay on your teeth.

These acids breaks down the enamel, that hard coating which covers teeth. Tiny weak spots can grow and become holes in the enamel. We call these holes cavities, and your dentist can repair them by cleaning away the decay and putting a filling in your tooth to protect it.

But it’s best to prevent cavities from ever starting by brushing and flossing. Even though plaque is sticky, it is easy to brush away when you do it every day.

• How Does Plaque Hurt Your Gums?

The gums surround our teeth and help protect them, but they are also delicate. When plaque builds up, it can irritate your gums.

You might notice that your gums get red, feel sore when you brush, or look puffy. You might have bad breath that doesn’t go away. All these are signs that your gums are reacting to the plaque around them.

The good news is that careful brushing and flossing can usually fix these problems. Talk to Dr. Varble, Dr. Dill, Dr. Wong, and Dr. Parks about taking good care of your gums.

• Can We Fight Plaque?

Yes! From the time you were small and learned how to brush, you’ve been learning how to fight plaque.

• Brush at least twice a day for two minutes, and be sure to brush all around each tooth and the gums.
• Floss to remove plaque from where it hides between the teeth and near the gums.
• Visit our Creve Coeur or St. Charles office for a cleaning, to remove plaque from hard-to-reach places and to learn the best ways to brush and floss.

As soon as you finish brushing, plaque starts to build up again. But no need to worry! Keep brushing, flossing, and visiting us for regular cleanings, and all your careful work will be rewarded will a beautiful, healthy smile.

When it comes to gum disease and your child, it’s a good news/bad news situation. The very good news is that children rarely suffer from advanced gum disease, or periodontitis. The not-so-good news? Early gum disease, called gingivitis, is unfortunately an all-too-common childhood problem.

• What does gingivitis look like in children?

Childhood gingivitis has the same causes and symptoms as the adult version. Healthy gums are firm and pink. When bacteria and plaque accumulate on the teeth, your child’s gums become irritated and inflamed. Call our Creve Coeur or St. Charles office right away if you notice any of these symptoms of gingivitis: bleeding gums, puffiness, redness, gum tissue receding from the teeth, or bad breath even after brushing.       

• How to Prevent Gingivitis

The most common cause of gingivitis is poor dental care. Creating a regular dental routine is the best way to prevent gingivitis from ever developing! Brushing and flossing with your child for two minutes twice a day from the very beginning helps make healthy cleaning a lifelong habit. Care should be taken to gently brush teeth at the gum line to make sure plaque doesn’t get a chance to build up there and cause gum irritation. And when your child comes in for regular cleanings, Dr. Varble, Dr. Dill, Dr. Wong, and Dr. Parks can be sure that any plaque that might remain on the teeth is removed.

Two additional notes: as your child approaches adolescence, hormone fluctuations can make gums more sensitive and easily irritated. This is a time to really emphasize careful and gentle brushing and flossing. Also, some medical conditions may make children more pre-disposed to gum problems, so be sure to make us aware of your child’s medical history.

• Uncommon Gum Diseases

While gingivitis is very preventable with proper dental hygiene, there are some rare gum conditions that can occur around the time of puberty that are quite different from gingivitis. Aggressive Periodontitis can cause severe bone loss around the first molars and incisors, even without any kind of plaque build-up, and Generalized Aggressive Periodontitis leads to inflammation of the gums, heavy plaque, and, eventually, loose teeth. Again, these conditions are rare, but if you have a family history of these diseases, let us know. Checkups and cleanings are a great way to catch any potential gum problems, so be sure to bring your child in for regular visits.

Almost all childhood gingivitis is preventable. With careful brushing and flossing at home, and visiting us regularly for checkups and cleanings, your child can enjoy healthy gums and teeth now and learn habits that will keep those gums and teeth healthy for a lifetime. And that is a good news/great news situation!