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Today’s braces have come a long way. Braces are less conspicuous, easier to keep clean, and, often, treatment takes less time than it did in the recent past. With early intervention and modern treatment techniques, orthodontists are able to help make your orthodontic journey more confident, carefree, and efficient.

Even with all of the benefits of modern orthodontics, though, there are still some reasons that a tooth should be extracted to give a patient the best, healthiest alignment and bite. When might your orthodontist recommend an extraction?

• Large teeth and/or a small jaw can mean that there’s just not enough space for your overcrowded teeth.
• The placement of a tooth or teeth make it impossible to correct a bite problem.
• Your wisdom teeth are impacted or erupting, and are likely to interfere with your bite and/or crowd your teeth.
• You have an extra, or supernumerary, tooth—a rare occurrence which can cause crowding, tooth displacement, or even block a healthy adult tooth from erupting.

If your orthodontist recommends extraction, it makes a lot of sense to ask for a referral to an oral and maxillofacial surgeon like Dr. Matthew Hilmi. Why an oral surgeon?

• Anything other than a simple extraction requires surgical treatment, and your oral surgeon has spent years of additional specialized medical study and training after dental school focusing specifically on facial, jaw, and dental surgeries.
• Oral surgeons know how to deal with complicated extraction issues and potential complications. Teeth that lie close to a nerve, teeth that are impacted, or teeth with long, curved roots most often mean that surgical extractions are the best and safest options.
• Your oral and maxillofacial surgeon is trained to administer all forms of anesthesia, including not only local anesthesia but a variety of sedation options as well. You can decide on the method that will make you most comfortable.
• Oral surgeons have a wealth of experience in extractions, whether simple or complicated, because this procedure is performed regularly in their offices.

If your orthodontist has recommended an extraction in order to achieve your healthiest bite and alignment, ask about our Kingston oral and maxillofacial surgery office.

Have you been having trouble getting a good night’s rest?

Sometimes the reason for a poor night’s sleep is obvious. A midnight horror movie. A bedtime espresso. That anchovy and pineapple pizza you had for dinner. Not much we can do about these problems.

Sometimes, though, the cause of your sleep difficulties is dental in origin, and that is something Dr. Matthew Hilmi can help with.

Teeth grinding, or bruxism, is a very common dental problem. When people with this condition sleep, their jaws clench and their teeth grind against each other throughout the night. When to suspect you might suffer from bruxism?

• You wake with a sore jaw, or you hear pops or clicks when you move your jaw
• You suffer from frequent headaches or facial pain
• Your teeth are chipped, cracked, flattened, worn down, or sensitive
• You wake up tired, because grinding affects the quality of your sleep
• Partners, siblings, or roommates complain about nocturnal grinding noises affecting the quality of their

Pain and fatigue are unpleasant enough, but there are additional serious consequences for those who suffer from bruxism. Our jaws are extremely powerful, and clenching and grinding can put hundreds of pounds on pressure on teeth and jaws over hours of sleep. These forces can lead to:

• Damaged teeth. Cracked, chipped, and worn down teeth can mean veneers, crowns, and root canals. Seriously compromised or broken teeth might need to be extracted.
• Damaged dental work. Bruxism can lead to fractured veneers and damaged fillings and crowns. If the damage is too serious for repair, replacement might be necessary.
• Damaged jaw joints. Severe cases of bruxism can lead to injury to the temporomandibular joint, or TMJ, the complex hinge that allows our jaws to move up and down, back and forth, and side to side.

While these problems can be treated with restorations, or root canals, or implants, or surgical procedures, prevention is clearly a much better option for a healthy smile. And one of the simplest and most effective treatments for preventing the damage caused by bruxism is a night guard.

Night guards fit over the affected teeth to prevent them from touching directly, saving tooth and enamel from injury and wear. Not only do night guards prevent contact, they spread the biting forces of the jaw over the surface of the guard to greatly reduce their impact. And because they also stop the jaw muscles from clenching tightly, there’s no excess stress placed on the temporomandibular joint.

While over-the-counter products are available, a dental professional is the best person to see for the most effective night guard. A custom night guard is designed to fit your individual teeth and mouth perfectly. Impressions or 3D scans are taken in the office, and a guard is fabricated with the precise shape, strength, and thickness you need to protect your teeth. And, as a bonus, custom night guards offer the most comfortable fit for the most comfortable night’s sleep.

If you suffer jaw pain on a regular basis, schedule a visit to our Kingston office. Oral and maxillofacial surgeons specialize in treating conditions of the jaw and facial bones. We can diagnose the source of your jaw pain and prescribe treatment, whether the cause is bruxism or any other jaw disorder.

Scary movies, late night caffeinating, creative food combinations—not much we can do about those! But if you’re suffering lost sleep and painful mornings because of tooth grinding, give us a call. In many cases, a night guard just might be the key to sweet dreams.

When your wisdom teeth start to emerge it can definitely be painful, but it can be even worse if your wisdom teeth become impacted. Impacted wisdom teeth are trying to erupt but are unable to do so because there is not sufficient room for them to emerge. This usually means that your wisdom teeth are painfully lodged in your jawbone.

While you may not see any real signs of the emerging wisdom teeth when they are impacted, what you can’t see can still definitely hurt you. Some of the indicators of impacted wisdom teeth are listed below.

• Jaw Pain: Pain in the back of your jaw is a common indicator of impacted wisdom teeth. The pain often concentrates in the area around your gums.
• Changes in the Mouth: You may notice some changes in your mouth when you have impacted wisdom teeth. Reddish gums, swelling in the jaw, bleeding gums, and bad breath can all be indicators that you are dealing with impacted wisdom teeth.
• Headaches: If you suddenly start having headaches, especially at the same time as some of the other issues mentioned above, they may indicate impacted wisdom teeth.
• Chewing Issues: Problems with chewing normally can indicate impacted wisdom teeth. If you are having trouble making the chewing motions because your mouth won’t quite open and close as easily as it used to, impacted wisdom teeth may be the culprit.

The Solution

If you are suffering from impacted wisdom teeth, the best solution is usually going to be removal. This is not a problem that will resolve naturally, and in fact, your pain and other symptoms may worsen as your wisdom teeth become increasingly impacted. At Mid-Hudson Oral and Maxillofacial Practice, Dr. Matthew Hilmi can review the details of wisdom teeth removal surgery with you and help you determine if this is the best solution for your situation.

Getting to the Root of the Problem

While our roots are well protected, they’re not indestructible! Several conditions can damage them. But we’re not just about problems—we also have some suggestions to keep your roots solid and intact for a lifetime.

• Traumatic Injury

A blow, a fall from a bike, a sports injury—any trauma which can hurt your visible tooth can hurt your roots as well. And it’s not just accidents that cause harm. Cracks in the tooth caused by oral habits like chewing on ice, pencils, or other hard objects can lead to root fractures.

You can help prevent root injuries by wearing a mouth guard whenever you are engaged in contact sports or any physical activity that might cause damage to your face or mouth. If you have harmful oral habits, talk to Dr. Matthew Hilmi about how to break them. And if you do suffer a dental injury, see us as soon as possible to avoid more serious complications.

• Bruxism

Bruxism, or tooth grinding, is most often an unconscious habit that takes place while you sleep. Grinding puts enormous pressure on teeth and their roots. The damage can be obvious, with cracked and worn crowns, but your roots can be affected, too. The strain of this constant pressure can stretch the periodontal ligament, causing loose teeth.

Night guards are one of the easiest ways to relieve pressure on individual teeth and roots. Your dentist can fabricate a night guard which will provide comfortable, effective protection for your teeth and jaw.

• Infected or Injured Roots

Any infection or trauma which injures the pulp of the tooth will affect the roots as well. Most of us are familiar with root canal treatment, where infected or damaged pulp is removed, and the insides of the pulp chamber and canals are cleaned, shaped, and filled. A crown is usually placed afterward to cap and protect the tooth. 

Sometimes, however, an infection can persist after root canal treatment. An oral surgeon is a specialist in treating complex medical conditions of the face, mouth, and jaw. We may have been recommend to you if a surgical procedure is needed to treat infection around or in the root.

When infections persist near the tip of a root, an apicoectomy is a common surgical treatment. In this procedure, Dr. Matthew Hilmi will carefully remove a few millimeters from the tip of the tooth, then clean the infected parts of the root and the tissues around it before sealing the root tip.

Other surgical options are available to help prevent extractions when there’s a root problem. A healthy molar with only one root seriously damaged by infection, trauma, or decay can be treated with a root amputation. Here the injured root is surgically removed, preserving the remaining roots and crown. If part of the crown is damaged as well, Dr. Matthew Hilmi can perform a hemisection, dividing the tooth to save as much of the undamaged root and crown as possible.

• Gum Recession

Taking care of your gums is one of the best ways to protect your roots.

Gums often recede as we age, leaving part of the root exposed. Gum disease, failure to brush and floss regularly, and heavy-handed brushing can also lead to gum recession. The newly revealed cementum is now exposed to the plaque and acids that cause cavities in our enamel, and, since it’s not as strong as enamel, cementum is more vulnerable to erosion and cavities progress more quickly.

When more severe recession takes place, the gums pull away from the teeth, creating pockets which become home to plaque and bacteria. Left untreated, infection and inflammation can develop, attacking teeth, connective tissue, and bone.

Scaling and planing procedures which clean the root surface can help. If you could benefit from soft-tissue grafting to replace lost gum tissue, schedule a visit to our Kingston office to discover your options.

Healthy roots help you keep your teeth for a lifetime, so it’s important to see Dr. Matthew Hilmi as soon as possible if you have any symptoms of potential problems:

• Constant pain in tooth, gums, or jaw
• Pain when biting down
• Loose teeth
• Tooth discoloration
• Sensitivity to hot and cold
• Swelling or pain in the gums around a tooth

Do your part by keeping up with daily brushing and flossing, visiting Dr. Matthew Hilmi for exams as recommended, and making an appointment if you are feeling any pain or discomfort. If you could benefit from surgical treatment, talk to your oral surgeon about the most effective treatment options for your individual needs. Strong roots are essential to our oral health, and a lifetime of healthy smiles is something we’re all rooting for!