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As you age, it becomes even more important to take good care of your teeth and dental health. According to the Centers for Disease Control and Prevention, approximately one-fourth of adults age 65 and older have no remaining teeth. What's more, nearly one-third of older adults have untreated tooth decay.

Oral health, regardless of age, is crucial to overall good health. Ideally, we all want to keep your natural teeth, but whether you're caring for natural teeth or dentures, advancing age may put older adults at risk for a number of oral health problems, including:

• Dry mouth
• Diminished sense of taste
• Root decay
• Gum disease
• Uneven jawbone caused by tooth loss
• Denture-induced tissue inflammation
• Overgrowth of fungus in the mouth
• Attrition (loss of teeth structure by mechanical forces)
• Oral cancer

These conditions may not be diagnosed until it is too late. If you want to feel good, stay healthy, and look great throughout life, you might be surprised what a difference a healthy mouth makes.

Here are some tips for maintaining and improving your oral health as you become older:

• Brush twice a day with a toothbrush with soft bristles. You may also benefit from using an electric toothbrush.
• Clean between your teeth once a day with floss or another interdental cleaner.
• If you wear full or partial dentures, remember to clean them on a daily basis. Take your dentures out of your mouth for at least four hours every day. It’s best to remove them at night.
• Drink tap water. Since most contains fluoride, it helps prevent tooth decay no matter how old you are.
• Quit smoking. Besides putting you at greater risk for lung and other cancers, smoking increases problems with gum disease, tooth decay, and tooth loss.
• Visit Alpine Oral and Facial Surgery regularly for a complete dental checkup.

If you have any questions about keeping up with your oral hygiene at home, please give us a call!

No one really looks forward to a wisdom tooth extraction, even a straightforward one. Fortunately, you can be confident that your oral and maxillofacial surgeon has the experience and the skill to make your extraction experience as safe and comfortable as possible.

But what happens when your situation is not quite so straightforward? Dr. Holtzen and our team have the experience and the skill to diagnose and treat these more complex extractions as well.

One of the potential complications with an impacted wisdom tooth is its close proximity to the Inferior Alveolar Nerve (IAN) of the jaw.  When the roots of the impacted tooth are fully developed, they can rest very close to, put pressure on, or, in rare cases, even wrap around this nerve.

Why is this a problem? Because these nerves supply feeling to the lower lip, gums, chin, and teeth. If a nerve is damaged during extraction, a patient might be left with pain or numbness in these areas, which can affect sensation, speech, and eating. While this nerve damage is usually temporary, in rare cases it can be permanent.

But an impacted tooth, left alone, can also have serious consequences—pain, infection, and damage to neighboring teeth and bone. So what’s the answer in this complicated case?

Talk to Dr. Holtzen. We have the training and skill to detect any potential nerve involvement when you need a wisdom tooth extraction, and we have a procedure to help prevent damage to the nerve if it lies too close to the roots. The coronectomy is a specialized surgery used only to treat impacted teeth when the nerves of the lower jaw might be compromised.

What is a coronectomy, exactly? The tooth can be thought of in two distinct segments—the crown, which is the part of the tooth that rises above the gum when the tooth erupts, and the roots below, which anchor each tooth in the jaw. A “coronectomy” means the removal (“ectomy”) of the crown (“corona”) of the tooth.

In this procedure, we will divide the tooth into two parts. After making a small incision to expose the tooth, the crown will be removed, and the root section left in the jaw. When the procedure is completed, the incision in the gums will be closed with sutures. Recovery is much like recovery for any other tooth extraction.

Once the coronectomy is completed, you might be asking, “What happens to those roots that were left behind?” Another good question!

• Very rarely, the roots become infected or cause irritation to surrounding tissue and will need to be removed.
• Occasionally, root fragments can start to emerge through the gums, just as a whole tooth would. But since they must move away from the nerve in order to erupt, they can be extracted without endangering the nerve.
• The most common result? The remaining root segment becomes permanently encased by bone tissue within the jawbone, never to cause problems again.

Are there times when, even though a wisdom tooth is bordering on a nerve, this procedure might not be advisable? Yes. Infection and decay in the tooth, tooth mobility, periodontal disease near the tooth, a horizontal tooth (where sectioning the tooth could damage the nerve), and other conditions might mean that a coronectomy is not possible. In that case, Dr. Holtzen can discuss further options with you.

No one really looks forward to wisdom tooth extraction. Fortunately, even in complicated situations, your oral and maxillofacial surgeon has the experience and the skill to provide the answers you need for an extraction experience that is as safe and comfortable as possible.

Any more questions? Contact our Missoula or Hamilton office to see if a coronectomy is the answer for you.

When you chip a tooth badly, it can be a very nerve-wracking situation. Dr. Holtzen and our team want to provide you with some information that can help if you ever suffer a chipped or broken tooth. The most common ways people break their teeth are by biting down on something hard, getting hit in the mouth, falling down, or developing cavities that weaken the tooth and allow it to be broken easily. There are a few things you can do if you find yourself in this situation, however.

First, we recommend that you investigate whether the tooth is partially chipped or completely broken. Unless you are experiencing a lot of pain or bleeding, this should not be treated as an emergency. You may call our office and we will try to schedule an appointment with you as soon as possible. Once we have evaluated the tooth during your appointment, we can start to treat it. For minor chips or cracks, we may simply smooth out the area or fill in the space so the crack doesn’t spread.

If your teeth show severe damage such as a serious break, split tooth, split root, or a decay-induced break, Dr. Holtzen may need to take more time to fix the problem. If you need emergency dental care because a tooth has fallen out, call our practice immediately to schedule an appointment for that day. If you’re waiting for an emergency appointment, you can rinse your mouth with warm salt water and apply slight pressure to the area to stop the bleeding. We recommend using an ice pack to reduce swelling, but do not take any aspirin because that may increase the bleeding.

If your tooth has completely fallen out of the socket, hold it by the crown and rinse it under running water. Do not let the tooth become dry; instead, place it in salt water or milk until you get to our office. Dr. Holtzen will determine whether the broken tooth can be salvaged or will need to be completely replaced.

We know how upsetting it can be to chip or break a tooth, which is why we want to guide you through this process. Most chipped teeth are usually just cosmetic problems, fortunately, but we know that dental emergencies can come up rather suddenly. Be sure to schedule an appointment at our Missoula or Hamilton office as soon as an emergency situation occurs.

If wisdom tooth extraction is on your calendar, it’s a good idea to visit your grocery store ahead of time to stock up on smart diet options for post-surgery meals. It might be a few weeks before you heal completely, so we have some shopping list suggestions which are safe, soothing, and nutritious to get you through your recovery.

Smart Choices

Soft, Smooth, and Creamy

• Soft-serve ice cream
• Frozen yogurt
• Yogurt
• Pudding

Now is a good time to indulge yourself, and ice cream, yogurt, and pudding are easy on sensitive tissue and filled with protein, calcium, and vitamin D. Just remember—choose soft flavors with no crunchy, sticky, or chewy additions.  This means no cones, as well. Most important? Nothing with a straw. Suction can cause the dislodgement of the protective clot over your extraction site. And dislodgement of this protective cover can lead to a painful condition known as dry socket.

Sometimes we recommend a wait on milk products immediately after surgery due to anesthesia, medication, or other considerations—we’ll let you know if that’s the case, and when you can safely enjoy dairy products.

Comfort(able) Foods

• Broth
• Pureed soups
• Applesauce
• Gelatin desserts
• Clear liquids

Foods that don’t require much chewing won’t irritate tender mouth and gum tissue. You can also find a wide variety of flavors to tempt your palate. Choose broths with higher concentrations of protein, and soups which provide minerals and vitamins. Nothing too hot, though—heat can affect the protective clot over the wound site. Applesauce is not only soothing and flavorful, but is a good source of fiber and vitamin C. Gelatin desserts and clear liquids will help you keep hydrated, which is extremely important as you heal.

Blender-Friendly Creations

• Smoothies
• Pureed foods

Want to get creative in the kitchen? Create your own smoothies and purees to suit your individual taste! Blended foods are easy to eat, and you can add vitamins with your choice of fruits and vegetables and proteins or protein powder for nutritional value. (Sip or eat smoothies with a spoon, as straws are still off-limits.)

You can gradually add semi-solid foods such as mashed potatoes, oatmeal, cottage cheese, and scrambled eggs as you recover. Don’t worry—we’ll give you aftercare instructions that will include what you should be eating and drinking right after surgery, and what you can add to your diet as you heal.

Unwise Diet Selections

It wouldn’t be sensible to leave you without some idea of which foods to avoid for the next few weeks. Talk to us about how and when to re-introduce these items to your diet.

• Grainy, seedy, or crunchy foods, which become tiny particles as you chew, can lodge in the surgical site.
• Spicy, carbonated, and acidic foods can irritate delicate gum tissue.
• Sticky and chewy foods can be hard on the extraction side.
• Hot beverages can interfere with the protective clot that forms over the wound.
• Alcohol can interact with medications and, according to several studies, potentially slow healing.
• Anything that requires a straw. Any kind of suction risks dislodging the protective clot at the surgical site. Eat your milkshake with a spoon—it’s still delicious!—and absolutely no cigarettes.

And one final word to the wise: seeing Dr. Holtzen for wisdom teeth extraction and follow-up is an excellent idea!

Oral surgeons like Dr. Holtzen have a minimum of four years of advanced studies in a hospital-based residency program, where they train with medical residents in the fields of general surgery, anesthesiology, internal medicine, and other specialties with a specific focus on the anatomy of the face, mouth, and jaw. They are uniquely qualified to make sure your wisdom tooth extraction and healing are successful.

If you have any questions about the procedure, and what you can do at home to help the healing process, give our Missoula or Hamilton office a call. We want to help you make the wisest choices for diet, pain relief, wound care, and all of your other aftercare needs.