Posts for: September, 2020
We Americans love our sports, whether as participants or spectators. But there's also a downside to contact sports like soccer, football or basketball: a higher risk of injury, particularly to the mouth and face. One of the most severe of these is a knocked out tooth.
Fortunately, that doesn't necessarily mean it's lost: The tooth can be reinserted into the empty socket and eventually return to normal functionality. But it must be done as soon as possible after injury. The more time elapses, the lower the chances of long-term survival.
That's because of how teeth are held in place in the jaw, secured by an elastic, fibrous tissue known as the periodontal ligament. When a tooth is knocked out some of the ligament's periodontal cells remain on the tooth's root. If these cells are alive when the tooth is reinserted, they can regenerate and reestablish attachment between the ligament and the tooth.
Eventually, though, the cells can dry out and die. If that has already happened before reinsertion, the tooth's root will fuse instead with the underlying bone. The tooth may survive for a short time, but its roots can eventually dissolve and the tooth will be lost.
Your window of opportunity for taking advantage of these live periodontal cells is only 5-20 minutes with the best chances in those earlier minutes. You should, therefore, take these steps immediately after an injury:
- Find the tooth, hold it by the crown (not the root end), and rinse off any debris with clean water;
- Reinsert the root end into the empty socket with firm pressure;
- Place clean gauze or cloth in the person's mouth between the tooth and the other jaw, and ask them to bite down gently and hold their bite;
- Seek dental or emergency medical care immediately;
- If you're unable to reinsert the tooth, place it quickly in a container with milk and see a dentist immediately.
You can also obtain an Android or IOS smartphone app developed by the International Association of Dental Traumatology called ToothSOS, which will guide you through this process, as well as for other dental emergencies. The quicker you act, the better the chances that the injured person's knocked out tooth can be rescued.
If you would like more information on what to do in a dental emergency, 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 “When a Tooth is Knocked Out.”
The long-running hit show Dancing with the Stars has had its share of memorable moments, including a wedding proposal, a wardrobe malfunction, and lots of sharp dance moves. But just recently, one DWTS contestant had the bad luck of taking an elbow to the mouth on two separate occasions—one of which resulted in some serious dental damage.
Nationally syndicated radio personality Bobby Bones received the accidental blows while practicing with his partner, professional dancer Sharna Burgess. “I got hit really hard,” he said. “There was blood and a tooth. [My partner] was doing what she was supposed to do, and my face was not doing what it was supposed to do.”
Accidents like this can happen at any time—especially when people take part in activities where there’s a risk of dental trauma. Fortunately, dentists have many ways to treat oral injuries and restore damaged teeth. How do we do it?
It all depends on how much of the tooth is missing, whether the damage extends to the soft tissue in the tooth’s pulp, and whether the tooth’s roots are intact. If the roots are broken or seriously damaged, the tooth may need to be extracted (removed). It can then generally be replaced with a dental bridge or a state-of-the-art dental implant.
If the roots are healthy but the pulp is exposed, the tooth may become infected—a painful and potentially serious condition. A root canal is needed. In this procedure, the infected pulp tissue is removed and the “canals” (hollow spaces deep inside the tooth) are disinfected and sealed up. The tooth is then restored: A crown (cap) is generally used to replace the visible part above the gum line. A timely root canal procedure can often save a tooth that would otherwise be lost.
For moderate cracks and chips, dental veneers may be an option. Veneers are wafer-thin shells made of translucent material that go over the front surfaces of teeth. Custom-made from a model of your smile, veneers are securely cemented on to give you a restoration that looks natural and lasts for a long time.
It’s often possible to fix minor chips with dental bonding—and this type of restoration can frequently be done in just one office visit. In this procedure, layers of tooth-colored resin are applied to fill in the parts of the tooth that are missing, and then hardened by a special light. While it may not be as long-lasting as some other restoration methods, bonding is a relatively simple and inexpensive technique that can produce good results.
If you would like more information about emergency dental treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor articles “The Field-Side Guide to Dental Injuries” and “Knocked Out Tooth.”
Do you remember when one of your baby teeth began to wiggle? You knew it wouldn't be long before it came out, followed by a little something from the “tooth fairy” under your pillow.
Those were the days! But a loose permanent tooth is something else entirely: Often a sign of advanced periodontal (gum) disease, you may be on the verge of losing the tooth forever.
This sad affair begins with dental plaque, a thin biofilm found on tooth surfaces and the ideal haven for oral bacteria that can trigger a gum infection. You might not notice such an infection in its early stages, other than a few initial signs like gum redness, swelling, or bleeding. If these occur, it's imperative you seek treatment promptly.
Without treatment, the infection can spread below the gum line, weakening gum attachments to teeth (which actually hold teeth in place) and eventually doing the same to underlying bone. All of this damage can lead to a tooth becoming loose and eventually falling out.
But it's not inevitable a loose tooth will eventually be lost, though it may require long-term efforts to save it. We may first need to do a bite adjustment, which will often allow a tooth to decrease its mobility. If the mobility has not been reduced enough, we may recommend stabilizing the teeth through splinting: These are techniques used to join the loose tooth to more stable teeth, usually with a thin strip of metal or other dental material.
We'll also need to treat the underlying cause, which in the case of gum disease requires aggressive plaque removal. Our goal is to manually remove all plaque and tartar (calcified plaque) deposits, particularly below the gum line. It may also require surgery to fully access deep pockets of infection. But once we remove the offending plaque, the gums can begin to heal.
The best strategy, though, is to avoid gum disease altogether. You can substantially lower your infection risk by brushing and flossing daily and getting a dental cleaning every six months. Dental visits also allow us to check your gums for any signs of infection that might require prompt action.
A loose tooth for a kid is a cause for celebration. It's the exact opposite for an adult loose tooth. Taking care of your gums with daily hygiene and receiving prompt treatment for any emerging infection could help you avoid it.
If you would like more information on treating 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 “When Permanent Teeth Become Loose.”