I usually recommend milder treatments to alleviate conditions before resorting to extractions, surgery or root canals.
For example if your tooth had a three surface cavity, many dentists would do a crown and build up. I might start with a three surface filling to see if that alleviates your problem. If the filling doesn’t hold up, you may need the crown in six months, but often times the less invasive — and less expensive –dental procedure will suffice.
This is not a recognized specialty in dentistry. Rather, it’s a term we use in our office to describe the Pagano Protocol – the sequence in which your teeth, gums and structure are treated which results in a dazzling smile that sits in a structurally sound foundation.
What do we mean by “orthopedic cosmetic dentistry?” Think of your teeth and gums as the inside of a house and your jaw and head bones as the structure and foundation. Once Doc ensures that the structure is balanced and stable – which often includes treatment that eliminates headaches,
teeth grinding and other unwanted conditions – then the restorative and cosmetic treatments on your teeth and gums can be performed on a stable foundation. This results in cosmetic treatment that lasts, a bite that feels natural, and eliminates redoing your work.
One patient with lifelong headaches experienced complete relief. Her treatment included straightening her teeth and getting a gorgeous smile.
You can read more about orthopedic dentistry in Doc’s free downloadable ebook: Lifetime Smile at www.stlouisdentistdrpete.com.
Summer is a popular time in St Louis for wisdom teeth extractions, particularly for young adults. When you as an adult or your child is diagnosed as needing wisdom teeth extracted, does this mean you need to have it done right away? What are wisdom teeth, why do we have them and under what circumstances should they be removed?
Wisdom teeth, also known as third molars, are the last teeth to erupt. This normally occurs between the ages of 17 and 25, a time of life that has been called the “Age of Wisdom.”
Anthropologists contend that the rough diet of early humans resulted in excessive wear of their teeth. The wear, it’s theorized, caused teeth to drift and by late adolescence there was space for wisdom teeth to erupt into. Modern diets don’t put the same demands on chewing and so teeth no longer shift to make room for wisdom teeth.
No. Dr. Pete believes that if wisdom teeth are well aligned, they can be very useful for chewing and may be left in place. However, in the majority of people they don’t completely erupt and remain “impacted” in the jaw. Therefore, Dr. Pete will advise extraction when he sees any of the following:
1. The width of the jaws does not allow wisdom teeth to erupt in an alignment that is beneficial for chewing.
2. Wisdom teeth are partially erupted, which may allow bacteria to penetrate the gum, causing infection.
3. Wisdom teeth are not properly aligned causing crowding or damage to the second molars. This condition makes good oral hygiene difficult and increases the likelihood of cavities and gum disease.
4. Development of an operculum, Latin for “little lid,” which is essentially an extension of the gum. This can occur when wisdom teeth have not fully erupted. In many such cases, chewing on food can irritate this operculum causing infection. This condition, called pericoronitis, can result in redness, intense pain, a bad smell and a difficulty of opening the mouth.
Is There a Benefit to Extracting Earlier Rather Than Later?
Possibly during adolescence, the roots of wisdom teeth may not be completely formed, making extraction less complicated.
Before removing a wisdom tooth, Doc will administer appropriate pain prevention to numb the area where the tooth will be removed. Even needle-phobes no longer need worry because Dr Pete’s dental procedure includes first putting a topical numbing agent on the area to be anaesthetized so the needle is never felt.
Dr. Pete recommends up to four to five days, but the time varies depending on how impacted the teeth are. One patient returned to work immediately after surgery. Another took the full four days for recovery.
If you or your teen or college-aged student need wisdom tooth extractions, call as soon as possible to lock in a summer appointment.
After having 2 wisdom teeth pulled in one sitting, I am a happy camper. Dr. Pete was fast and efficient removing the two perpetrators. Afterward there was minimal discomfort in the affected areas, little swelling and complications that could only be attributed to the work done by a skilled professional. Thank you Dr. Pete and Staff.
Guy M.
Let me just first start off that I was freaking out about this dental procedure, especially because I was not going to be knocked out like everybody else I knew. I was shaking and crying before anything even happened but of course you heard all the horror stories and all I could think was the worst. Dr. Pete calmed me down and explained what he was going to do and why he wasn’t going to knock me out. His lovely assistant held my hand the whole time, poor girl, I thought for sure she would loose all circulation in it but she didn’t complain and smiled at me the whole time. After the 1st 4 shots, I really couldn’t feel much and the next million (I’m exaggerating, but I am very sensitive) nothing at all. Before I knew it, it was over. The very next day, I was walking over and running errands. My roommates couldn’t believe it. They said “you must have an awesome dentist”. I said, “I do, his name is Dr. Pete!”EP posted on yahoo.com
When I first came to Dr. Pagano’s St Louis office, I was very apprehensive because he was a new dentist (to me). After my consultation and check-up Dr. Pagano informed me that I needed to pull my wisdom teeth, not 1, not 2 but all 3!! I was terrified because I had so many horrible experiences with dentists in the past. He assured me that everything would be fine. During the procedure he talked to me the whole time and kept letting me know what he was doing. This made me feel calm. He would ask me if I felt any pain and I did not. After my wisdom teeth were pulled I didn’t feel any pain nor did I need any pain medication! I’ve heard horror stories from people and their bad experiences with their wisdom teeth being pulled, but I had a good experience and that was due to Dr. Pagano’s skilled and talented hands. He knows what he’s doing and he’s the best! I recommend him to everyone I know and meet. Thank you Dr. Pagano.Abby J.
To Schedule a Wisdom Tooth Surgery Consultation With Dr Peter J. Pagano please call Brenda at 314 576 3000
12334 Olive Boulevard, Creve Coeur, MO 63141
One Block West of I 270 Olive Boulevard ExitSaturday hours available
Rather Than Dread Dentures, View Them as a Chance to Design Your Own Smile
Morton came in as a new patient asking for a new set of dentures. In collaborating with him so we
could make him dentures he would be proud to wear, I asked him questions such as:
Do you want spaces between your front teeth?
What type of smiles do you like?
Who do you want to look like?
Do you want big teeth, little teeth, long teeth, wide teeth?
Do you want personalization, such as little character flaws built into your teeth?
Do you want perfect alignment?
Morton told me he’d never been consulted to that degree like when getting dentures made previously.
He said for the first time ever, he was excited to get his new denture appliance.
According to the Center for Disease Control, 1 out of every 4 adults over 60 have lost all of their natural teeth due to gum disease and tooth decay. Another CDC report says 1 out of every 5 adults over 65 have lost all of their teeth. Once that occurs, your choices are dentures or implants.
Although dental implants are an excellent alternative to dentures, not everyone can get them. This doesn’t mean you have to dread dentures. The biggest reason denture wearers switch to implants is:
• Their dentures are ill-fitting and uncomfortable;
• They don’t like how their dentures look.
You can dread dentures or view them as an opportunity to design your smile. If you want to pay $99 and get “teeth-on-a-plate” then the old adage “you get what you pay for” applies.
On the other hand, if you want someone to craft an appliance that feels and looks natural, you can spend the money and get something that will make you feel confident.
As an Art Minor in college, I see beyond the science of dentistry. Although an appliance needs to be engineered perfectly, the aesthetic appeal must also be present.
If you need a denture, view it as an opportunity to design the smile you’ve always wanted.
For Boomers who grew up with this famous toothpaste commercial, I have a news flash: At your age, it’s no longer just about cavities!
If you’ve passed the age of forty, you really should have a mid-life diagnosis to evaluate the overall state of your oral health AND to plan a proper course of treatment that will enable you to keep your teeth for the remainder of your lifetime.
Patients over forty have often shortchanged their dental health or just barely maintained their teeth and gums. With the expense of family taking precedence through the previous two decades, Boomer-aged patients coming to me for the first time are often prepared to play catch-up with their own dental health.
Today you can plan a course of treatment that will ensure you’ve got your own teeth to chew with well into your senior years. In addition, nothing is more youthful than a natural-looking white smile. Unlike your parents, if you take care now you can have both.
One topic omitted from the anti-aging forum is the relationship of your teeth to how you look and feel every day. This area of medicine has long been excluded from discussions of longevity and wellness and categorized mostly as a cosmetic function, much like plastic surgery. Yet nothing could be further from the truth. Every tooth impacts a different area of your body. Every extraction has an impact on your longevity.
Why do we neglect the role our mouths play in overall health? Why do we accept missing teeth and dentures as a “natural” course of aging?
My answer is the extreme lack of information on the subject. Look for my book coming out soon.
A St Louis woman was referred to me who had constant pain in her front tooth and had been advised to extract the tooth. I observed that the problem tooth was constantly being hit by the tooth directly underneath it. I adjusted her bite. It immediately felt better. The next day her husband said he’d heard no more complaints about the tooth.
The same woman I just mentioned was looking to invest a sizeable amount on dental procedures in several different offices around town. She was recommended to me for a second opinion.
After examining her I knew she suffered from headaches, neck aches and low back pain. She was shocked that I knew this. All of the treatment other doctors had advised was correct — EXCEPT — there was one key component missing. She had a jaw joint that was out of place and no one addressed that.
Over time, this condition had created other dental problems, which included missing teeth on the side where the jaw joint was out of place. And of course, she had pain as a result of her condition.
Her proposed treatment addressed every aspect of her dental health — except her jaw joint problem. By individually consulting different doctors for various aspects of her treatment, she was trying to renovate her mouth without an overall coordinated plan.
I usually recommend milder treatments to alleviate conditions before resorting to treatment like extractions, surgery or root canals. For example if your tooth had a 3 surface cavity, many dentists would give you a crown and build up (a $900 procedure). I might start with a 3 surface filling to see if that alleviates your problem. If the filling doesn’t hold up, you may need the crown in 6 months, but often times the less invasive procedure will suffice.
