Month: July 2014

Pediatric Dentistry: Six-Year Molar

The six-year molar is the first permanent tooth coming into a child’s mouth. It is the first permanent molar and it comes up next to the very back baby molar tooth. This permanent tooth is different from other permanent tooth because it does not replace any other baby tooth. It just comes up behind the last baby tooth when the child is about six years of age.

The reason why I am writing this article is to make the parents beware of this tooth. Very commonly, parents does not know that this permanent tooth appears when the child is six years old. They would incorrectly think that this tooth could be just one of the baby tooth and it would eventually be replaced by permanent tooth later when the child is much older. So I have seen some child may have big cavity on the six-year molars and parents might become surprise that the tooth is actually a permanent tooth.

I would recommend that the parents would take their children to have their first routine checkup when the very first baby tooth erupts. Also, periodic checkup and cleaning would help ensure optimal dental health and also provide a chance for the dentist to provide useful dental information to the parents. And one of these useful information is about the six-year molar. It is my hope that the children would start off with good dental hygiene so to help them to continue do so as they grow up into adulthood.

Written by Daniel Tee, DDS, MS

Practicing Family Dentist Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona.

Faithful Wearing of Retainers is Important to Keep Teeth Aligned After Braces

After the braces, I would always have the patients wear retainers for their teeth. Retainer is a custom made device, usually made of either metal or plastic, and it is put on around the teeth in order to keep the teeth from moving. Teeth is supported by periodontal ligaments within the jaw bone, and these ligament fibers are like rubber band. After the orthodontic treatment, these ligaments are usually stretched as the result of teeth movement. Stretched ligament would tend to unstretch itself, thereby move the tooth back into the original misaligned position. In order to keep the tooth in the desired position, a anchoring retainer device is recommended.

I usually would have the patient wear the retainers continuously day and night time, except during eating, for the initial six months. The initial six months is critical because the teeth will have the most tendency to move back into their misaligned position. Then after that, the teeth position would become more stable. Then I would tell the patient to only have to wear the retainers at night time during sleep. I would recommend wearing the retainers for at least 2 years after the braces.

Written by Daniel Tee, DDS, MS

Practicing Family Dentist Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona.

Fosamax Can Cause Osteonecrosis to the Jaw Bone

Fosamax is a common drug used to treat osteoporosis and also Paget’s disease. In some rare cases, people may develop dental complications after dental extractions when they are taking fosamax. The jaw bone may never heal and osteonecrosis of the jaw bone may occur. There may or may not be infections. It may be asymptomatic for a couple of weeks until the exposed bone appears in the affected site.

There are other drugs that may cause osteonecrosis. They are bisphosphonate-category of drugs used to commonly treat cancers.

One way to minimize the chance of side effect is to have the physician to prescribe an alternative medication for the targeted medical illness.

So if you are taking fosamax, please be sure to discuss this with the dentist upon dental visit.

Written by Daniel Tee, DDS, MS

Practicing General Dentist Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona.

Xylitol Gum Promotes Dental Health

For those people who like to chew gums, they can chew the xylitol gum because it is known to inhibit the growth of cavity-causing bacteria. The active ingredient is xylitol, which is not readily digested by bacteria as energy source. Instead, it is taken up by the bacteria cell and it accumulates within the cell and leaving no room for other energy-producing sugar. Thus, the bacteria will starve and die.

Also chewing action also promotes secretion of saliva. Saliva helps wash away food debris and the enzymes within the saliva help kill off the bacteria.

Written by Daniel Tee, DDS, MS

Practicing General Dentist Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona.

Professional Teeth Cleaning Is Necessary for Dental Health

Professional Teeth Cleaning by Dental Proessionals, such as the dentist and hygienist, at the dental office is absolutely necessary part of maintaining good dental health. Often, dental toothbrush and floss might not be able to remove all plaque and calcified food debris on the tooth. The food debris would accumulate in between the two adjacent teeth and also within the gum pockets around the teeth. The bristles on the toothbrush might not be able to get into these areas to remove these food debris. In addition, these food debris could be calcified and they strongly adhere onto the surface of the tooth. Thus, it becomes necessary to have the dental professionals to use special instruments called the scaler to get into these areas and remove the food debris. Failure to remove food debris from these areas would cause the periodontal disease, infections and tooth decay.

When a person comes in for teeth cleaning, dentist would give a dental checkup exam and review if there is any dental problems.

It is recommended to have dental cleaning and checkup at least two times per year. If a person has periodontal disease, he might need to have periodontal treatment followed by routine periodontal cleaning once every three months.

Written by Daniel Tee, DDS, MS

Practicing Family Dentist Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona.

Why does Wisdom Tooth Hurt? Pericoronitis

Typically, adult has four wisdom teeth and they don’t come in until a person’s late twenty years old.  Often, people will complain about pain caused by the wisdom tooth.  There are many reasons why wisdom tooth causes pain.

Just like other tooth, wisdom tooth would have to push through the gum tissue when it is coming in.  During the process of eruption, the eruption movement of the wisdom tooth causes pressure to the adjacent tooth and the gum tissue, so as the result, it might cause discomfort and perhaps pain.

In addition, the wisdom tooth might grow side way (or horizontally impacted.)   It can be totally submerged under the gum tissue or it may be half way showing through the gum tissue.  If it is impacted and is unable to break through the gum tissue completely, the food is more lilely to be jammed in between the wisdom tooth and the adjacent tooth.  Bacteria will feed off from the jammed food debris and infection will occur.  The bacteria infection will cause inflammation of the gum tissue around the wisdom tooth.  The technical term of this inflammation is called pericoronitis.  The gum tissue around the wisdom tooth might appear reddish in color (in comparison to the pinkish color of normal gum tissue) and might be swollen.

The treatment would be antibiotics for short term control of the infection but it is generally recommended to have the wisdom tooth removed for prevention purpose.  Failure to remove the wisdom tooth might cause many major dental problems.  See my previous article for more information.


Written by Daniel Tee, DDS, MS

Practicing General Dentist Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona.

Impacted Wisdom Tooth Can Causes Major Dental Problems

In this article, I would talk about the necessity of removing impacted wisdom tooth and I will show one of my recent cases relating to the impacted wisdom tooth.

Typical adult has 32 teeth and four of them are wisdom teeth located at the most posterior area of the dental arch.  Often these wisdom teeth don’t come in until a person’s late twenty years old.  Even though they don’t seem to cause any pain, it is recommended to have the wisdom teeth extracted for preventive purpose.

It is generally difficult to clean the wisdom teeth because it is located at the most posterior region of the mouth.  Sometimes, the wisdom teeth can grow sideways.  Detanlly we called them impacted wisdom teeth.  If the wisdom teeth are impacted, food and bacteria can accumulate around the wisdom teeth because food is more likely to get caught in between the wisdom tooth and the tooth in front of it.  If left ignore, continual jamming of food will allow bacteria to grow and causes tooth decay, on the wisdom tooth and also on the tooth in front of the wisdom tooth.

Xray Image of Impacted Wisdom Tooth Causing Dental Decay, Pull Wisdom Tooth extraction, Pull Third Molar, Wisdom Teeth extraction

Xray Image of Impacted Wisdom Tooth Causing Dental Decay

I have this patient come in with the toothache.  Upon examination of Xray, we can see that the impacted wisdom tooth causes severe decay on the tooth in front of it.  The decay has already progressed onto the nerve chamber of the tooth.

So in order to treat her dental problems, I would perform surgical removal of the wisdom tooth and for the damaged tooth, I would remove all decay, perform root canal therapy, buildup the tooth and follow by the crown.

The main reason why the decay has progressed is because the patient does not have the habit of going to see the dentist for routine checkup, and also follow through the previous dentist’s recommendation of extracting the wisdom teeth.

Often the type of dental problem created by the wisdom tooth can be difficult to address because the decay can be very deep and dental restoration may not be able to be placed to restore the tooth.  Luckily, in the above case, the decay has not compromise the structural integrity of the tooth and I was able to restore the tooth.


Written by Daniel Tee, DDS, MS

Practicing General Dentist Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona.

Osteoporosis Causes Loose Teeth

Osteoporosis is a common skeletal disease which causes the weakening of the bone structure and as a result, the bone fracture occurs.  The disease can exist in the jaw joint and jaw bone.  It causes periodontal problem and eventually it may contribute to loosening of teeth and ultimately, tooth lost.

Woman may have more periodontal problem than men.  Especially after menopause, the changes in female hormone may cause osteoporosis and this affects the condition of their teeth and bone support around them.

In elderly age, osteoporosis may cause damage to the bone support of teeth.  Even if they are edentulous (or lack of any teeth), osteoporosis can cause the loosening of their denture because the denture relies on the ridge bone for support.  If the bone within the ridge are weakened, the denture may not have adequate support and become destabilized.

Dentist can help diagnosis and treat periodontal disease, decreasing the detrimental effect of osteoporosis.


Written by Daniel Tee, DDS, MS

Practicing Tempe Family Dentist Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona.

Invisalign — Invisible Way to Straighten Teeth

Invisalign is one of the orthodontic treatment for straightening teeth.  Traditional orthodontic treatment consists of using metal brackets and wire to move teeth.  For invisalign, a set of multiple clear trays is precisely designed from digital impression of the patient’s teeth and they are used to move teeth in precise controlled manner.  Let me demonstrate how it is done.

Invisalign BeforeThis is one of my recent invisalign patient.  She comes in with upper and lower mild crowding of teeth.  She would like to have especially the front teeth straightened.  From my experience, invisalign is very effective at correcting this type of dental problem.  So I offer invisalign to the patient.

I would take a set of xray radiographs and also photographs of the patient’s teeth.  Then I would take upper and lower impression of patient’s teeth.  I gathered all of these information and then send it to invisalign lab.

After a few days, the invisalign lab would have scanned the impression into a digital copy.  I would then design the treatment in the computer.  I would specify the type and degree of movement for each teeth.   The computer software would create treatment simulation for this patient based on my specification.

My staff would call the patient back to my office for reviewing the treatment proposal and the computer simulation.  If patient has any questions, I would then make modification to the treatment.  With patient’s approval of treatment, I would notify the invisalign company to fabricate a set of clear aligner trays.  These aligner trays are like the mouth guard.  They are stiff but also resilient.  They can control the teeth movement according to the pre-defined treatment path.

Invisalign Clear Aligners, Orthodontist, Orthodontic Treatment

Invisalign Trays are clear and fit perfectly on teeth

For this patient, 10 sets of upper and lower trays were fabricated.  The patient would wear each set of aligner for 2-3 weeks.  After the first set of aligner, she would change to the next set of aligners in sequence.




Invisalign After PhotoAfter 6 months, she has completed the treatment and this is how her final result looks like.  Notice her upper and lower teeth are now straight.  She is very happy for her new smile.

I would make a special retainer for her so that her teeth can be kept in proper position.


Written by Daniel Tee, DDS, MS

Practicing Family Dentist Serving the city of Tempe, Chandler, Phoenix, Gilbert, and Mesa in Arizona.