Not so ‘wise’ Wisdom teeth

Wisdom teeth (3rd molars) normally erupt between 17 and 25, hence the name.

A very long time ago, they were very useful in helping us break down foliage, but are now they are pretty vestigial. There may be several reasons for this. Our more refined diet has led to much less wearing down between the teeth (which helped to make room at the back) and there has also been a reduction in jaw size with this softer diet, and yet our teeth have not significantly changed in size to adapt to this.

Every week I hear Wisdom teeth being accused of causing incisor teeth to crowd up. There is lots of evidence comparing people with wisdom teeth and those missing wisdom teeth that have shown they all have identical amounts of crowding so Wisdom teeth are at least vindicated of this crime.

These days Wisdom teeth seem to rarely fit in properly leaving them unerupted or partly erupted and hard to clean right at the back. NICE (National Institute of Clinical Excellence) produced guidelines in 2000 limiting the cases in which wisdom teeth can be removed to mostly cases where the wisdom tooth is diseased or where it is causing other problems with the mouth. That is very different from the approach 20 years ago when I was relieved of all four of my symptomless and unerupted wisdom teeth under General Anaesthetic!

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Toothpaste – Everything you need to know

Early toothpastes –The Greeks used crushed bones and oyster shells. Later on ‘tooth powders’ were made with chalk, salt and brick dust!

Modern toothpastes have several more sophisticated components

Abrasives– like Aluminium Hydroxide and Silicas. If too abrasive it can dull the enamel, cause sensitivity and make enamel more translucent (showing up the
yellow dentine below)

Fluoride- Sodium Fluoride (NaF) is the commonest. It strengthens enamel, repairs early decay and controls gingivitis. ‘Full-strength’ toothpaste (<1500ppm) is advised for all ages (just a ‘smear’ of toothpaste for under 3s).

Surfactants Sodium Lauryl Sulphate is a foaming agent which helps distribute the toothpaste evenly.

Other Additives – Strontium Chloride and Potassium Nitrate can reduce sensitivity. Sodium polyphosphate can reduce the formation of tartar.

Whitening toothpastes – The abrasive in these toothpaste remove the stains but cannot alter the natural color of teeth. Abrasives polish the teeth and agents like Sodium Tripolyphosphate help break down stains. Two of the most effective seem to be Beverley Hills and Colgate Max White One.

Weird Facts  – After using toothpaste, orange juice and other juices have an unpleasant taste. This may be due to a chemical reaction between Stannous Fluoride and the acetic acid in the juice. Sodium lauryl sulfate (surfactant) alters taste perception. It can inhibit taste receptors for sweetness, making food taste bitter. However Apples can taste more pleasant after using toothpaste!

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60 years of Dentistry - what has changed?

60 years of Dentistry – what has changed?

  • 1950 50% of all adults would expect to loose all their teeth and wear dentures during their life
  • 1952 first dental Implant placed. Not widely used in UK until 1990s
  • 1957 High-speed dental drills (Borden Airotor) released- 10 times faster so much more comfortable and quicker but are recognisable to a generation of patients due to their characteristic whine
  • 1965 Fluoride toothpaste launched (Signal)
  • 1970 Limited water fluoridation introduced in the UK
  • 1980 Dental Composites – white fillings were greatly improved and released for use on back teeth
  • 1990 Dental Lasers released for operating on gums and later jaw bone
  • 2000s Now many children have no decay and can expect to keep all their natural teeth for the rest of their lives
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