Wednesday, July 29, 2015

Pulling Teeth--What to Expect

At some point in people's lives, a tooth may need to be pulled. This can certainly cause much anxiety. I will briefly describe the process and attempt to alleviate any fears.

Here is what to expect:

Before the actual tooth is pulled, there are measures taken to ensure a positive experience. Medications are often given to create a feeling of relaxation. Anesthetic gels are used prior to the administration of anesthetic agents to ensure pain is completely blocked. The anesthetic will usually kick in within about 5-10 minutes.

I typically inform everyone what to expect prior to initiating treatment. I mention that there should not be any sensation of pain whatsoever. If someone were to experience pain, I tell them to inform me immediately. You don't have to be tough. You just need to be numb.

We can eliminate the sensation of pain, but we cannot eliminate the sensation of touch or pressure. So, I will let the patient know ahead of time that they will feel pressure. The reasoning for this is that if they are anxious and not told what to expect, they may interpret the pressure as pain. Once that happens, It may be difficult to convince them that it is only pressure.

In addition, I inform them that they may hear some noises. This is especially true when removing wisdom teeth since they are in close proximity to the ears. Hearing noises in our mouths can be scary. Things that occur within our mouths tend to sound louder than they really are such as when we eat certain foods like potato chips. Simply knowing that there may be noises and not have them come as a surprise is all that is necessary to alleviate most people's fears.

Most of the time sutures are not required. In most cases, Ibuprofen is all that is required for pain control. If Ibuprofen does not alleviate the pain adequately, then a narcotic pain medication can be taken.

Oral and written instructions are given to avoid any complications such as "dry sockets". The vast majority of patients recover quite well with minimal discomfort.

If the extractions are performed under sedation, the patient will typically have no memory of the procedure.

In conclusion, pulling teeth should not be a big ordeal. The worst part of it is often the anticipation of a negative experience. Most often, the experience is quite positive. I know, many of you reading this may think this is absurd, but it is actually true that most patients do quite well.

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit

Thursday, July 16, 2015

Three Things That Influence How Long You Keep Your Teeth

Many of my patients desire to keep their teeth for their entire lifetime. I often tell them that there are three primary things that will determine whether or not they can keep them throughout their entire lives. Those three things are Diet, Hygiene and Habits. Simple enough right?


A diet consisting of highly refined sugars is the primary reason why decay is more prevalent now than a century ago.

Extended exposure to these refined sugars cause a significant amount of decay in teeth. There are several ways this occurs.

First, if we it eat sticky foods, they will adhere to the surfaces of the teeth for extended periods. This in turn will allow the bacteria to process the sugars and convert them to acids. The acid is what demineralizes the teeth and causes cavities to develop.

Secondly, if we eat foods that stay in the mouth for extended periods such as hard candy, suckers and chewing gum, the result is the same.

A third way this occurs is by drinking sugary drinks over extended periods of time. It would be much better for someone to drink a large soda in a short period of time rather than to drink a small soda over an extended period such as during an entire movie.


Basically, we should be brushing a minimum of twice a day and preferably more. We should brush upon awakening and prior to sleeping. We should also brush after each meal.

Don't forget to floss. You need to floss daily. If you fail to floss, you will not remove the debris that forms in between the teeth. You will therefore develop cavities in between the teeth.


Avoid parafunctional (things that aren't normal) habits such as chewing on ice, chewing on your fingernails, using your teeth to open bottles or cutting fishing line or tearing beef jerky. These are just some examples.

Another habit that will undermine your ability to keep your teeth for life is smoking. Smokers tend to have more bone loss around their teeth. So, even if the teeth themselves are healthy, if there is no supporting bone around them, you will still lose your teeth.

Clenching and grinding are also very detrimental habits. Consider your car. Typically, you may be able to get a few hundred thousand. However, if you abuse it and and race it, you'll be lucky to get twenty thousand miles out of it.

The bottom line is, use your teeth only to eat normal foods. 

In conclusion, a good diet, good hygiene and good habits will help keep your teeth. 

Dr. Cisneros maintains a practice in Freeburg and Columbia, IL. Both are in the Greater St Louis, MO area. For more information on a wide variety of subjects, please visit