hi it's dr amanda with straightsmile solutions streetsmilesolutions.com and
today we're going to be talking about all kinds of dental work we're going to
be talking about dental work and how it relates to your
orthodontic treatment timing of things when to get wisdom
teeth out when to get implants when to get bridges how that affects your
orthodontic or a liner treatment or your braces treatment
so much to talk about this is probably going to be a long video
and i have my handy dandy little typodont that i got today to help you
guys out understand things a little bit more
so let's start with the first things first let's talk about wisdom teeth it's
a super popular subject so let's talk about the different classifications of
wisdom teeth and my personal opinion on what you
should do if you have wisdom teeth before
ortho so first of all it depends on your age right
um you know if you're 12 13 14 we're probably fine
but if you're 17 18 19 20 through maybe 25
we might want to get them out if you're older than 30 you've had them for a
while you're probably okay we're probably fine so the age is a big
deal now let's talk about the position of the
wisdom teeth and how that might affect things okay
so ideally wisdom teeth remember are teeth number 1
16 17 and 32 okay so tooth number one okay is right here
all right 16 17 and 32 okay so those are
the last teeth you're going to get in your mouth and a lot of times they get
stuck and they never ever come in and sometimes they come in and you have
to get them pulled out because they're so far
back there and they don't come in perfectly and you get gum infections and
cavities and they end up really causing a lot of pain so most people end up
getting them out just as a precautionary preventive situation
so that they don't cause a lot of pain and swelling
and they can even kill you if they get infected they can travel up to your
brain they can travel down to your lungs i'm sorry down to your to your neck a
lot of dangerous things can happen with an effective wisdom tooth
that's why most military people i think they have to have this pulled out before
they go to boot camp or get deployed so um you know just to be safe and
healthy so but ultimately that's your choice you
know so let's talk about positioning so if
they're impacted there's a couple different ways they can be impacted
so and you need an x-ray in order to see this so this is a vertically impacted
one this one doesn't scare me very much i don't mind you leaving that
there's always a risk that it might damage the adjacent roots to the healthy
number tooth next to it but for the most part it probably won't
mess with your ortho so it's okay would be my answer to that you
want to get it out get it out you want to leave it leave it just keep your eye
on it make sure you're keeping everything
clean and get your x-rays taken regularly but also a good idea to get it
out second one that you have very often
would be an erupted one it comes in but it comes in kind of funky
like this one okay so this is going to kind of mess up your bite so in this
case usually orthodontists don't straighten
wisdom teeth they just don't you don't rotate predictably maybe you
could do it easily with invisalign if you had a scanner
most of the time we're just going to suck it out so it's just really not that
useful it's a tiny tooth and but you know ultimately your choice
okay so if a wisdom tooth comes in all the way
straight i'm fine you can keep it okay um what else what about this one
right here this is an impacted one can you see it
it's impacted it's under the bone but it's partially
impacted that means part of the crown is erupted can you see
it right there oopsie sorry so part of it
is above the gum surface this is the most dangerous one
this one is most likely to cause infections pain severe infections
like ones that might end you up in the hospital like at a random time
no no warning it's basically a ticking time bomb if it's days like that that
needs to come out asap goodbye get it out definitely before ortho 100
um high likelihood that it's gonna transfer decay to the other tooth and
possibly kill this tooth as well and you can see this tooth is actually already
dead because it has an affection so
that's why we want to get that out and lastly we have
the sleeping tooth it's like a wisdom tooth that's sleeping it's on its side
it's taking a nap it's horizontal instead of vertical we don't like that
one either because the crown is touching the roots
of a healthy tooth it can cause trouble it can cause
movement it can cause decay it can cause pressure it can cause pain
this is this serves no purpose to you so get it out there might be a point in
time though that when you have one of those
that you can't get it out if it's too close to a nerve there is a nerve that
runs around here and it's too close to the nerve if it's
already too developed you're probably gonna have to keep it and just manage it
so better to grab these before you get too old and the roots become too
developed and get too close to the nerf so that's
why it's important to get wisdom teeth out during
proper timing most people get them out maybe 16 17 18 19 20 college times
um around college time i think i got mine out when i was like 20.
um some people have four wisdom teeth some people have two some people have
three some people have one some people are lucky and have none
i had two i think my daughter has three i think my son has none
so you know lucky but anyways that's all about
wisdom teeth let's move on more things to talk about now we're going to talk
about implants so implants
are screws okay that are drilled into the bone now here you've got two
implants here this is actually implant supported bridge it's not just a single
unit implant um but you get the idea so basically the
way it's going to work is that usually it's done in a two-step
process where either a periodontist an oral
surgeon a prosthodontist or a general dentist
will go ahead and put the screw in it's really important that your teeth
that are adjacent to it are parallel which is why if you're thinking about
getting orthodontics i recommend getting your function first and then getting
implants placed that way it'll just be way more accurate
way better way better outcome so sometimes people
do things the other direction will manage it if so you just won't
quite get as good of an outcome because you can't move those teeth right
because they're stuck to the bone so it gives us
less teeth to work with usually it's a two-step process where they're going to
screw the screw in first let it integrate with the bone and get
healthy and then they're going to load it with the with the restorative crown
or whatever it is later sometimes it's screwed in sometimes it's cemented
so a couple different ways to do that but that's usually the way it works so
again this is usually done after ortho if you are thinking about
getting an implant or a bridge you should really consider an
orthodontic system that takes x-rays and utilizes x-rays as a requirement that
would be my suggestion because you will get a way way way better outcome
if you do that there are some systems out there that don't use x-rays
so i'm just letting you know on the front end that's a question you'd want
to ask i would always do that if you're doing a
bridge on implement it's probably not quite as critical that is with an
implant what else that's pretty much it i'll
show you the difference between an implant
and a bridge just so you can see so you saw the
screw retain implants now this is just a typical bridge two healthy teeth
ah if i can get it off pretty sure this is a bridge
okay oh there we go two healthy teeth they take two healthy teeth
and they reduce them down to little nubs which i think is kind of sad
because if you just had one space here why would you wanna
potentially kill two other teeth you might need root canals
um they're not going to last that long just to fill in a space with a bridge
right it doesn't make sense to me but this is old school new school would be
an implant bridges maybe last five to ten years
implants can last a lifetime when they're done right
so and you don't have to worry about flossing and they're just like a regular
tooth they're really they're really really good teeth so
definitely i would always pick an implant over a bridge assuming you have
the bones in order to be able to support it of course if you're a smoker
or you have health problems that may not be an option because it really depends
on how healthy your bone is uh history of head and neck cancer
radiation there's all kinds of taking bisphosphonates
there's all kind of medical contraindications for implants sometimes
so again i'm not an implant surgeon i'm not especially specialist in implants i
just prepare teeth to get them ready for people to get implants but i do know
somewhat about them so anyways that's all about wisdom teeth
third molars implants bridges um you know
other things to talk about would even be crowns
so you can see here there's a crown well actually this is an implant retained
crown so this is a single unit implant crown
um and it just goes on like this it's another thing lots of different
fancy restorative work so lots of great doctors out there and the
good thing about the team at proline is that we're an interdisciplinary team
and on our team we have orthodontists we have general dentists we have all kinds
of people who understand how to work with
other doctors and patients and we'll be glad to help you out all right thanks so
much have a good day