According to Forbes Magazine, Kylie Jenner is the world's youngest billionaire at age 22. Daughter of Caitlyn (Bruce) Jenner and Kris Jenner, Kylie is the founder and owner of the highly successful Kylie Cosmetics, and a rising celebrity in her own right. But even this busy CEO couldn't avoid an experience many young people her age go through each year: having her wisdom teeth removed.

At around 10 million removals each year, wisdom teeth extraction is the most common surgical procedure performed by oral surgeons. Also called the third molars, the wisdom teeth are in the back corners of the jaws, top and bottom. Most people have four of them, but some have more, some have fewer, and some never have any. They're typically the last permanent teeth to come in, usually between ages 17 and 25.

And therein lies the problem with wisdom teeth: Many times, they're coming in late on a jaw already crowded with teeth. Their eruption can cause these other teeth to move out of normal alignment, or the wisdom teeth themselves may not fully erupt and remain fully or partially within the gums (a condition called impaction). All of this can have a ripple effect, decreasing dental function and increasing disease risk.

As Kylie Jenner has just experienced, they're often removed when problems with bite or instances of diseases like tooth decay or gum disease begin to show. But not just when problems show: It's also been a common practice to remove them earlier in a kind of “preemptive strike” against dental dysfunction. But this practice of early wisdom teeth extraction has its critics. The main contention is that early extractions aren't really necessary from a medical or dental standpoint, and so patients are unduly exposed to surgical risks. Although negative outcomes are very rare, any surgical procedure carries some risk.

Over the last few years, a kind of middle ground consensus has developed among dentists on how to deal with wisdom teeth in younger patients. What has emerged is a “watch and wait” approach: Don't advise extraction unless there is clear evidence of developing problems. Instead, continue to monitor a young patient's dental development to see that it's progressing normally.

Taking this approach can lead to fewer early wisdom teeth extractions, which are postponed to a later time or even indefinitely. The key is to always do what's best for a patient's current development and future dental health.

Still, removing wisdom teeth remains a sound practice when necessary. Whether for a high school or college student or the CEO of a large company, wisdom teeth extraction can boost overall dental health and development.

If you would like more information about wisdom teeth and their impact on dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth: To Be or Not to Be?”

There are many things to be concerned about with your infant. Thumb sucking shouldn't be one of them—at least not yet. Practically universal among young children, the habit normally fades by age four with no real harm.

If it persists beyond that age, however, it can lead to a poor bite (malocclusion). Late thumb sucking may also have a connection with another problem—the inability of a child to transition from an infantile swallowing pattern to an adult pattern.

A baby while swallowing thrusts their tongue forward to help create a seal around a breast or bottle nipple during nursing. This normally changes about age 4, though, to a positioning of the tongue against the roof of the mouth when swallowing. But if they don't transition and continue to thrust the tongue forward, it can place undue pressure on the front teeth and cause them to develop too far forward.

The result may be an open bite, in which a gap exists between the upper and lower teeth even when the jaws are shut. An open bite can also happen with late thumb sucking, but instead of the tongue, their thumb presses against the teeth.

As to thumb-sucking, parents should encourage their child to stop the habit beginning around age 3, if they haven't already begun to do so. The best approach is to use some form of positive reinforcement such as praise or treats. The sooner the habit ceases after age 4, the lower their risk for developing an open bite.

You may also need to be alert to continued tongue thrusting while swallowing, which may still continue even after they no longer suck their thumb. In that case, your child may need orofacial myofunctional therapy (OMT), a series of exercises directed by a trained therapist to retrain the muscles involved with swallowing. This therapy could further help a child properly transition to an adult swallowing pattern.

Open bites can be corrected orthodontically later in life. But by being alert to your child's oral habits, as well as the way they're swallowing, you and your dentist may be able to intervene and eliminate or at least lessen the development of this type of problem bite.

If you would like more information on how to manage thumb sucking, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Thumb Sucking Affects the Bite.”

It wasn't too many years ago that e-cigarettes were promoted as a healthier alternative to traditional cigarettes. “Vaping” was in and “smoking” was out.

But vaping's recent link with certain lung disorders, especially among younger users, has slowed the promotion train down considerably. And if respiratory health isn't enough, there's another reason to be wary of the practice—it's possible effect on oral health.

An e-cigarette is a handheld device with a reservoir that holds a mixture of water, flavoring, nicotine and other chemicals. The device heats up the liquid to transform it into a vapor that's then inhaled by the user. Technically, the vapor is an aerosol, a gaseous substance containing solid particles from chemical compounds.

Within this aerosol are a number of ingredients that can have a harmful effect on your teeth and gums. Foremost among them is nicotine, a chemical that's also a major ingredient in regular tobacco. Nicotine causes constriction of blood vessels, including those supplying the teeth and gums.

As these vessels constrict, they deliver to the teeth and gums fewer nutrients and antibodies to control infection. As a result, users of nicotine products, whether tobacco or e-cigarettes, will have a compounded risk for dental disease over a non-user.

E-cigarettes may in fact be worse than regular cigarettes in regards to nicotine. Cigarette nicotine is primarily inhaled into the lungs, while e-cigarette nicotine is absorbed by the mouth's mucous membranes, a much more efficient transfer. It's estimated that the amount of nicotine in one e-cigarette cartridge equals the nicotine from 20 cigarettes.

Nicotine isn't the only ingredient in e-cigarettes that could harm your mouth. Chemicals within the flavorings can irritate and dry out the mucous membranes of the mouth, as well as damage tooth enamel. There are a variety of other chemicals present like formaldehyde that could raise your risk for oral cancer.

Rather than a healthy alternative to smoking, e-cigarette users may simply be trading one form of health risk for another—and, in the case of your oral health, just as bad or worse. The best alternative for healthier teeth and gums is to leave both habits—smoking and vaping—far behind.

If you would like more information on vaping and oral health, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Vaping and Oral Health.”

If you think periodontal (gum) disease is something that only happens to the other guy (or gal), you might want to reconsider. Roughly half of adults over age 30—and nearly three-quarters over 65—have had some form of gum disease.

Gum disease isn't some minor inconvenience: If not treated early, a gum infection could lead to bone and tooth loss. Because it's inflammatory in nature, it may also impact the rest of your health, making you more susceptible to diabetes, heart disease or stroke.

Gum disease mainly begins with dental plaque, a thin film of food particles on tooth surfaces. Plaque's most notable feature, though, is as a haven for oral bacteria that can infect the gums. These bacteria use plaque as a food source, which in turn fuels their multiplication. So, the greater the plaque buildup, the higher your risk for a gum infection.

The best way to lower that risk is to reduce the population of bacteria that cause gum disease. You can do this by keeping plaque from building up by brushing and flossing every day. It's important for this to be a daily habit—missing a few days of brushing and flossing is enough for an infection to occur.

You can further reduce your disease risk by having us clean your teeth regularly. Even if you're highly proficient with daily hygiene, it's still possible to miss some plaque deposits, which can calcify over time and turn into a hardened form called tartar (or calculus). Tartar is nearly impossible to remove with brushing and flossing, but can be with special dental tools and techniques.

Even with the most diligent care, there's still a minimal risk for gum disease, especially as you get older. So, always be on the lookout for red, swollen or bleeding gums. If you see anything abnormal like this, see us as soon as possible. The sooner we diagnose and begin treating a gum infection, the better your chances it won't ultimately harm your dental health.

If you would like more information on the prevention and treatment of gum disease, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “How Gum Disease Gets Started.”

Ashley Graham has a beautiful and valuable smile—an important asset to her bustling career as a plus-size model and television host. But she recently revealed on Instagram a “confrontation” between one of her teeth and a frozen oatmeal cookie. The cookie won.

Holding her hand over her mouth during the video until the last moment, Graham explained how she sneaked a cookie from her mom's freezer and took a bite of the frozen treat. Taking her hand from her mouth, she revealed her broken tooth.

Okay, maybe it wasn't an actual tooth that was broken: the denticle in question appeared to have been previously altered to accommodate a porcelain veneer or crown. But whatever was once there wasn't there anymore.

Although her smile was restored without too much fuss, Graham's experience is still a cautionary tale for anyone with dental work (and kudos to her for being a good sport and sharing it). Although dental work in general is quite durable, it is not immune to damage. Biting down on something hard, even as delicious as one of mom's frozen oatmeal cookies, could run you the risk of popping off a veneer or loosening a crown.

To paraphrase an old saying: Take care of your dental work, and it will take care of you. Don't use your teeth in ways that put your dental work at risk, tempting as it may be given your mouth's mechanical capabilities.

 Even so, it's unwise—both for dental work and for natural teeth—to use your teeth and jaws for tasks like cracking nuts or prying open containers. You should also avoid biting into foods or substances with hard textures like ice or a rock-hard cookie from the freezer, especially if you have veneers or other cosmetic improvements.

It's equally important to clean your mouth daily, and undergo professional cleanings at least twice a year. That might not seem so important at first since disease-causing organisms won't infect your dental work's nonliving materials. But infection can wreak havoc on natural tissues like gums, remaining teeth or underlying bone that together often support dental enhancements. Losing that support could lead to losing your dental work.

And it's always a good idea to have dental work, particularly dentures, checked regularly. Conditions in the mouth can change, sometimes without you noticing them, so periodic examinations by a trained dental provider could prevent or treat a problem before it adversely affects your dental work.

We're glad Ashley Graham's trademark smile wasn't permanently harmed by that frozen cookie, and yours probably wouldn't be either in a similar situation. But don't take any chances, and follow these common sense tips for protecting your dental work.

If you would like more information on care and maintenance of cosmetic dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers: Strength & Beauty as Never Before” and “Dental Implant Maintenance.”