It can happen in an instant — your child takes a hard hit to the mouth while playing football, basketball or some other contact sport. Suddenly, he or she faces the severest of dental injuries: a knocked out tooth.
There's both good and bad news about this situation. First, the good news: the knocked out tooth can be reinserted into its socket and take root again. The bad news, though, is that the tooth has only the slimmest of chances for long-term survival — and those chances diminish drastically if the reinsertion doesn't take place within the first five minutes of the injury.
Outside of the five-minute window, it's almost inevitable that the tooth root won't reattach properly with the tiny fibers of the periodontal ligament, the sling-like tissue that normally holds the tooth in place to the jawbone. Instead, the root may fuse directly with the bone rather than via the ligament, forming what is called ankylosis. This will ultimately cause the root to melt away, a process known as resorption, and result in loss of the tooth.
Of course, the resorption process will vary with each individual — for some, tooth loss may occur in just a few years, while for others the process could linger for decades. The best estimate would be four to seven years, but only if the tooth receives a root canal treatment to remove any dead tissue from the tooth pulp and seal it from possible infection. Over time the tooth may darken significantly and require whitening treatment. Because the tooth may be fused directly to the jawbone it can't grow normally as its neighbor teeth will and thus may appear uneven in the smile line. From a cosmetic point of view, it may be best at that time to remove the tooth and replace it with an implant or other cosmetic solution.
In many ways the longevity of the tooth post-injury really depends on time — the time it takes to reinsert the knocked out tooth into its socket. The quicker you take action, the better the chances the tooth will survive.
If you would like more information on treating a knocked out tooth, 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 “Knocked Out Tooth: How Long Will a Tooth Last After Replantation?”
Whether you are a serious or “weekend” athlete, you know the importance of protecting yourself against injury. While looking after your joints, ligaments and bones may garner most of your attention, you shouldn't neglect looking after your teeth and mouth as well. In fact, there are more than 600,000 emergency room visits each year for sports-related dental injuries. A knocked out tooth could eventually cost you $10,000 to $20,000 in dental treatment during your lifetime.
The best protection is really quite simple — wear a properly-fitted athletic mouthguard. Researchers estimate that mouthguards may prevent more than 200,000 dental injuries annually. Be aware, though — not all mouthguards are alike or provide the same level of protection.
Mouthguards generally fall into three types. Stock mouthguards are the least expensive of the three, and also the least effective at protection. They come in limited sizes and can't be customized to the wearer. “Bite and Boil” mouthguards are made of thermoplastic that becomes pliable when heated (as when boiled in water). In this state the mouthguard can be pressed into the wearer's teeth, which hardens to that fit once the thermoplastic cools. However, the fit isn't exact and they don't always cover the back teeth. Also during the heat of competition, the mouthguard softens and loses some of its stability and protection.
While more expensive than the other two types, a custom-fitted mouthguard made by a dentist provides the best level of protection. Made of a tear-resistant material, they are more comfortable to wear than the other types and cover more of the interior of the wearer's mouth.
A properly fitted and worn mouthguard protects the mouth and jaw area in a number of ways. It cushions the soft tissue of the lips and gums from cuts and abrasions caused by contact with sharp teeth surfaces after an impact. It absorbs and distributes forces generated in an impact that can cause tooth loss or even jaw fracture, and also cushions the jaw joint (TMJ) to reduce the likelihood of dislocation or other trauma.
A custom-fitted mouthguard can cost hundreds of dollars, but that price is relatively small compared with the physical, emotional and financial price you'll pay for an injury. This investment in your oral health is well worth it.
If you would like more information on the use of athletic mouthguards, contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Athletic Mouthguards.”
Taking care of your teeth is a lifetime commitment, if you want your teeth to last a lifetime. But it can be especially challenging if you're wearing traditional metal braces. With a little extra attention, though, you can reduce the risk of dental disease during orthodontic treatment.
The goal of oral hygiene is to remove biofilm, a layer of leftover food particles called plaque that is a haven for disease-causing bacteria. Orthodontic braces make access more difficult for performing oral hygiene. A little extra effort and attention, though, can make a big difference.
First, be sure you're eating a healthy diet and avoiding unhealthy snacks (especially those high in carbohydrates) between meals; this will discourage the growth of bacteria in the mouth. You should also limit your intake of sodas, sports or energy drinks since their high acidity contributes to tooth enamel erosion.
Although more difficult for someone wearing braces, brushing is still essential to good hygiene. Begin by holding a soft, multi-tufted bristle brush at a 45-degree angle, and then brush the surface area between the gum and the braces all the way around. Return to your starting point and brush the area from the braces to the edge of the top of the teeth in the same direction. Be sure you do this for both the upper and lower jaw and on both the cheek and tongue side.
Flossing is also more difficult, but not impossible. Instead of conventional floss thread, you can use special floss threaders, small interdential brushes, or an irrigation device that sprays pressurized water to remove food particles between teeth.
Above all, it's important to keep up regular office visits with us. In addition to monitoring overall dental health, we can also apply or recommend additional fluoride products to help strengthen teeth or prescribe antibacterial rinses to reduce the mouth's bacterial level.
Keeping up a good daily hygiene regimen and regular checkups will ensure that the smile you gain from wearing braces is healthy as well as beautiful.
If you would like more information on oral hygiene while undergoing orthodontic treatment, 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 “Caring for Teeth During Orthodontic Treatment.”
In modern times, metals have played an important role in tooth preservation and restoration. From the dental amalgam used for a century and a half to fill cavities to the titanium alloy of dental implants, your dental care would not be as comprehensive as it is today without them. But could these metals, so important in providing oral health, cause an allergic reaction in some people?
An allergy is an exaggerated response of the body’s immune system to any substance (living or non-living) it identifies as a threat. The response could be as minor as a rash or as life-threatening as a systemic shut-down of the body’s internal organs. An allergy can develop with anything, including metals, at any time.
A low percentage of the population has an allergy to one or more metals: some surveys indicate 17% of women and 3% of men are allergic to nickel, while even fewer are allergic to cobalt and chromium. Dermatitis patients seem to have a higher reaction rate, some allergic even to metals in jewelry or clothing that contact the skin.
Dental amalgam, an alloy made of various metals including mercury, has been used effectively since the mid-19th Century to fill cavities; even with today’s tooth-colored resin materials, amalgam is still used for many back teeth fillings. Over its history there have been only rare reports of allergic reactions, mainly localized rashes or moderate inflammation.
The most recent metal to come under scrutiny is titanium used in dental implants. Not only is it highly biocompatible with the human body, but titanium’s bone-loving (osteophilic) quality encourages bone growth around the implant’s titanium post inserted into the jawbone, strengthening it over time. But does titanium pose an allergic threat for some people? One study reviewed the cases of 1,500 implant patients for any evidence of a titanium allergy. The study found a very low occurrence (0.6%) of reactions.
The conclusion, then, is that the use of metals, especially for dental implants, carries only a minimal risk for allergic reactions and none are life-threatening. The vast majority of dental patients can benefit from the use of these metals to improve their oral health without adverse reaction.
If you would like more information on metal allergies with dental materials, 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 “Metal Allergies to Dental Implants.”
There are some people, particularly women around the age of menopause, who experience an uncomfortable burning and dry sensation in their mouths most of the time. The exact cause of this condition, known as “burning mouth syndrome,” is often difficult to determine, though links to a variety of other health conditions have been established. These include diabetes, nutritional deficiencies (of iron and B vitamins, for example), acid reflux, cancer therapy, and psychological problems. Hormonal changes associated with menopause might also play a role.
If you are experiencing burning sensations and dryness, please come in and see us so we can try to figure out what's causing these symptoms in your particular case. We will start by taking a complete medical history and getting a list of all the medications you are taking as some drugs are known to cause mouth dryness. We will also give you a thorough examination.
In the meantime, here are some ways you might be able to get some relief:
Give up habits that can cause dry mouth such as chronic smoking, alcohol and/or coffee drinking, and frequent eating of hot and spicy foods.
Keep your mouth moist by drinking lots of water. We can also recommend products that replace or stimulate production of saliva.
Try different brands of toothpastes, opting for “plain” varieties that don't contain the foaming agent sodium lauryl sulfate, whiteners, or strong flavoring such as cinnamon.
Keep a food diary of everything that you put into and around your mouth (including food, makeup and personal care products). This might give us some clues as to what's causing your discomfort.
Check with us about any medications you are taking, either prescription or over-the-counter. We can tell you if any are known to dry out the mouth and maybe help you find substitutions.
Reduce stress in your life if you possibly can. This might be achieved through relaxing forms of exercise, joining a support group for people dealing with chronic pain, or seeking psychotherapy.
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.