寄せられた質問への回答5

いつもツイート拝見しています。 突然のdm失礼します。 歯に関する質問なのですが、よかったらご回答お願いできたらと思いましてdmいたしました。 先日親知らずと親知らずから数えて2つ前の奥歯を抜糸いたしました。
親知らずは横に倒れており痛みが出ていたので抜歯したのですが、普通の奥歯の方は神経治療済みで数年経った時に硬いものを食べた時に破折し、しばらくは銀歯をかぶせてなんとかなっていたのですが完全に歯根まで折れてしまっていたので今回抜歯して親知らずを移植することになりました。
移植後なのですが、親知らずの抜歯はうまく行き、ドライソケットにもならず順調に回復しておりますが、移植した歯が軽くぐらつき、歯の内部が脈打つ感じで軽い痛みと違和感がすごくあります。
それを先ほど先生に伝えたのですが、「抜歯してそこに歯を糸で固定しているので気にしなくていいですよ」とだけ言われ消毒のみで終わりました。
結局帰宅した今も口の中の不快感は大きく、何も処置していただけなかったのが残念なのですが、歯医者の先生の観点ではこれは普通のことですか? 一応3週間ほど様子を見たいと言われていたので仕方ないのかなと思ってはいるのですが…

親知らずの移植を行ってくれる先生自体がそう多くありません。外科が得意な先生でないと親知らずの移植は中々難しいと思います。私も移植は行いますが、患者さんの理解がないとトラブルに繋がる可能性の大きい歯医者側にリスクのある治療と考えています。

そして移植後は基本的に3週間から1か月経過しないと移植した歯が安定する事はないので現時点でグラグラしている事に問題はないと思います。

歯医者さん側は最善の処置をしてくれていると思いますので、移植のような成功率がそこまで高いとは言えない治療を積極的に行ってくれた事に感謝して先生の判断に今後も任せていけば良いと思います。

ちょっと趣向が違うかもしれませんが、ご質問させていただきます。
僕は非常に弱い扁桃腺(むしろ強いせいか?)で悩んでいたのですが、まず口腔環境を良くしようと電動歯ブラシなどを導入するなど試行錯誤してきました。 その中で一番圧倒的に効果があったのが歯磨き粉でした。
フッ素特化のものに変えたら驚くべきほど扁桃炎の頻度が下がったのです。具体的にはチェックアップ。
逆に合わないものは扁桃炎になりやすくなるなどのものもありました。(あくまで体感の話ですが)
フッ素系歯磨き粉の口腔環境への影響について知りたいのですが、ご存知でしたらご教授お願い致します。

扁桃腺炎の原因は ライノウイルス、コロナウイルス、アデノウイルス 等によるもが多く、細菌性の扁桃腺炎もありますが、フッ素にウイルスや細菌に効果があるという文献は今の所私は見た事がございません。
ですのでもしかするとの話ですが、フッ素が効果的というのではなく、チェックアップはフッ素がお口の中に長い時間滞留するような成分となっており、それによってお口の中が保湿されることによって、扁桃腺になりにくくなっているのではないでしょうか。
特に論文ベースでデーターがあるわけではないので、仮に本当に効果があるのであればそのような推測となりますが、実際この意見が正しいという保証は全くないのでそういう意見があるのだという程度に考えて頂ければと思います。

くろさん こんにちは。
いつも為替取引をする際に参考にさせて頂いてます。 歯の矯正についてご相談させて下さい。 当方29歳男性、親知らず未抜歯、歯の磨きすぎ(?)で歯茎が若干減退気味、顎関節症です…
最近、写真に写る自分の顔を見て、歪んでるなと思うことがあり、矯正を考えています。 しかし、矯正に対して恐怖心があります。
下記について教えて頂けないでしょうか?
1.年齢的に矯正して大丈夫なのか?
2.矯正により骨が溶けないか?
3.失敗して日常生活に支障をきたすリスクもあると思っておいた方が良いのか?
4.近年、儲け主義の歯医者が増えたように感じていて、信用できる歯医者が少ないです…矯正を行う際に選ぶべき歯医者のポイントを教えて頂きたいです…

こんにちは。新年早々に風邪をひいてしまい回答が遅れてしまい申し訳ありません。

まず大切な事はしっかりとした診断を受ける事です。顔の歪みの原因がかみ合わせが原因でない可能性もありますし、顔の歪みと言っても様々ですので普段から頬杖等の癖でも顔が変形したりします。

1に関してですが、年齢は問題になる事はありません。2について同時にお答えすると、矯正治療により歯の周りの骨が溶け歯茎が退縮してしまう可能性はあります。特に歯茎の状態が良くないのに矯正治療を行ってしまったケースで多く見られます。リスクとベネフィットを天秤にかけ矯正を行った方が良いか判断していきます。

3に関してですが、顎の不調和の是正まで必要なケースとなると外科的矯正と言って全身麻酔によって骨切り手術を受けなければならないケースもありますので、そのパターンだと入院等も必要になりますしそれ相応のリスクもありますから主治医からリスクについてよく説明を受けて下さい。

矯正治療は歯科の中でもかなり術式が変化している分野ですし、様々な流派がありメリットデメリットがあります。矯正の名医を探すのは非常に難しいのですが、矯正医の専門医制度というものがあるため最低でも専門医の資格を有している先生の治療を受けるようにしましょう。難しい所ですが、あまり年配すぎる先生は避けた方が無難かもしれません。素晴らしい1流の先生もいらっしゃいますけど。矯正をやっていない良さそうな歯科医院を最初に受診し、そちらで矯正の先生を紹介してもらうという手段も良いかもしれません。

とにかく1番大切な事は、今回は診断です。主訴に関して本当にかみ合わせが原因なのかどうかまずは1度相談してみてください。その回答に疑問があれば再度相談に乗らせて頂きたいと思います。

親知らずの抜歯について教えてください。
下の親知らず2本が虫歯のため抜歯を考えているのですが、CTを撮ったところ歯の根と神経が非常に近くほとんど重なっている状態だそうで、しかも根が若干歪んでいるらしく、抜歯後に神経麻痺が起こる可能性が高いと言われています。神経麻痺は1年程度続くそうなので、そうなることはなんとか避けたいのですが、こういった難しいタイプの親知らずの抜歯は担当医によって結果が変わるものでしょうか。そうである場合、どのようにして良い担当医を見つければ良いでしょうか。よろしくお願いします。

厳密に術者の腕を比較する事は難しい所ですが、様々な論文で神経麻痺が起こる確率が論文によりバラつきがある事も踏まえると術者の腕が関係すると私は考えております。

しかしどんなに優秀な外科医でも神経麻痺は起きる時は起きますので神経麻痺が起きた=術者の腕が悪かったというわけではありません。

腕の良い外科医を判別するのは困難で、まして親知らずの抜歯程度だと研修医だったり若手歯科医師が行う事が殆どです。しかも腕は私の知る限りは酷い事が多いです。

ですから本当に外れを引きたくなければ実際に歯科医師に聞いてみて尊敬を集める口腔外科医を直接名指しで紹介してもらうしかないように思います。

こればかりは中々お役に立てなく申し訳ございませんが。

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