Posts for: September, 2013
When you or a family member takes a traumatic hit to the mouth, what should you do? Besides immediate first aid, your next action will depend on the extent of damage to any teeth. What you do and when you do it may even determine whether an injured tooth is eventually saved or lost.
If a tooth has been completely knocked out, you have about five minutes to replace the tooth in the socket to give it the best chance of reattachment and long-term survival. While we can certainly perform this action in our office, getting to us within five minutes may not be possible. Fortunately, any person can perform this action on site (see the article linked below for basic instructions on replantation). If for some that's not possible, you should control bleeding at the tooth site with direct pressure, place the recovered tooth in milk or the patient's saliva, and see us as soon as possible.
If, however, the injured tooth has been obviously knocked out of line but not completely detached from its socket, you have a small cushion of time to seek dental treatment — but not much. For this degree of injury, you should see us within six hours of the incident. We will be able to determine the exact nature of the injury, and treat the condition by moving the teeth back into proper position and splinting them.
You have up to twelve hours for broken or chipped teeth still in their normal position. Try to locate and save any broken-off fragments — it may be possible to re-bond them to the teeth. Although it may not be as urgent as other situations, you should still seek treatment as soon as possible. A broken tooth could leave the inner pulp exposed — a situation that left untreated could lead to eventual tooth loss.
Traumatic injuries to the mouth can have serious consequences for your long-term dental health. With our consultation and treatment efforts, we can help you save an injured tooth.
If you would like more information on caring for dental injuries, 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 “The Field-Side Guide to Dental Injuries.”
As dental implants increase in popularity, the surgical procedures to install them are becoming quite commonplace. Still, many people are nervous about this procedure, perhaps not really knowing what to expect. So if you're considering dental implants, here's a rundown of what happens before, during and after the procedure.
Dental implants are actually a tooth root replacement system. A post made of titanium is inserted into the jaw bone at the site of the missing tooth. Because of titanium's bone-friendly molecular structure bone cells naturally gravitate to its surface; over time the inserted post and bone will fuse. After a few weeks of this process, the post will be ready for a porcelain crown, bridge or overdenture to be attached to it.
Before the implant surgery you will undergo a complete dental exam. Everything is planned out in advance so that we know the exact location along the jaw to place the implants. In many cases we create a surgical template that can be used during surgery to identify these precise locations.
The procedure itself is painless for most patients, requiring only a local anesthesia. The procedure begins with small incisions in the gum tissue to allow us to see the precise point in the bone for the implant. We then create a small hole in the bone, using a drilling sequence of successive larger holes until we've achieved the best fit for the implant (during drilling you may experience a mild vibration). We then remove the implants from their sterile packaging, place them immediately into the drilled hole, then stitch the gum tissue back into place.
After surgery, most patients encounter only a mild level of discomfort for a day or two. This can be managed by prescription doses of common pain relievers like aspirin or ibuprofen, although we will use surgical strength ibuprofen. Rarely do we need to prescribe something stronger.
Once the implant fuses permanently with the bone, we then affix the final crown or other dental device in a painless procedure. This final step will give you back not only the use of your teeth, but a more appealing smile as well.
If you would like more information about dental implant surgery, 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 “Dental Implant Surgery.”
Are the following statements true or false?
Thumb sucking in children may cause problems with their teeth later on.
Prolonged thumb sucking may be responsible for many problems with the bite. The constant pressure of the thumb itself can create a gap between the top and bottom teeth in front, a condition called an “open bite.” It also reinforces the habit of using the “tongue thrust” motion in swallowing, where the tongue is positioned between top and bottom teeth. This habit may also block full eruption of the front teeth.
Infants and young children swallow exactly the same way that adults do.
When they swallow, young children use what is called the “infantile swallowing pattern.” In this method, which begins before their teeth have erupted, the tongue is thrust forward in the mouth, sealing and supporting the lips. In adult swallowing, the tongue touches the roof of the mouth, behind the front teeth. The transition from the infantile method usually happens naturally, by around age 4.
Most open bites result from the habit of positioning the tongue too far forward.
Failure to transition between the infantile and adult swallowing pattern is believed to be the cause of most open bites. The tongue's position alone may prevent the front teeth from fully developing. Allowing the thumb to rest between the teeth has the same effect — and it can also push the front teeth forward. Other causes of an open bite are skeletal or jaw-related problems.
It is harder to cure open bites caused by thumb sucking or bad tongue position than those from other causes.
Open bites that are caused by skeletal factors (patterns of bone growth, etc) are often difficult to resolve. Those caused by dental factors (tongue position, tooth eruption, etc) are generally easier to fix. However, the pressure exerted by the thumb over a long period of time can influence bone growth in the jaw.
There is a dental appliance that can help discourage thumb sucking.
A thin metal “tongue crib” placed behind upper and lower incisors discourages the thumb-sucking habit. It also helps to “re-train” the tongue, keeping it from going between upper and lower teeth. To successfully treat an open bite caused by dental factors, and to prevent its reoccurrence, it is essential to eliminate the unhelpful habits of both the thumb and the tongue.
If you would like more information about thumb sucking or open-bite problems in children, 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.”
If you think you'd rather wrestle a pack of porcupines than go to the dentist for a root canal treatment — then maybe it's time to think again! This common procedure has been the butt of jokes for a long time. Let's set the record straight by answering some common questions about the much-maligned procedure.
Q: What is a root canal?
A: Coursing through the central part of each root is a hollow space or canal, which contains the pulp tissue. The pulp tissue contains the nerves which respond to temperature changes transmitted through the tooth. When the temperatures are extreme the nerves signal sensitivity and pain. It's also shorthand for the dental procedure that is performed when the pulp tissue that fills these canals develops a disease.
Q: Why do I need to get a root canal?
A: Because an infection or inflammation has developed deep inside one or more of your teeth. When the living pulp tissue — which contains nerves and blood vessels — becomes inflamed or infected, it can cause intense pain. It also releases bacterial toxins, which can lead to further problems.
Q: What happens if I don't get a root canal?
A: Your acute pain may temporarily go away, but the infection won't. It will eventually travel through the tooth's roots into the surrounding tissues. If left untreated, it may result in an abscess or even a systemic infection. That's why you need to take care of it now.
Q: Will it be painful?
A: Generally, a root canal procedure is no more painful than getting a filling. In fact, it starts the same way: An anesthetic is given to numb the tooth and the surrounding area. Then a small hole is made through the tooth's chewing surface and down into the canal. Diseased pulp tissue is removed through the hole via a set of tiny instruments. Finally, the root canal is cleaned, disinfected, filled with inert biocompatible material and sealed up.
Q: What happens after that?
A: Your tooth may be sensitive for a few days after the treatment, but the acute pain will be gone. Over-the-counter pain relievers generally work well for pain relief at this point. To restore your tooth to its fully-functioning state, a crown or other restoration is usually needed after root canal treatment. Properly done, the restored tooth can last as long as any of your natural teeth.
Q: Is there an alternative?
A: Yes. You can relieve the pain by having the tooth removed. But you don't want to go there. Tooth loss can lead to unwanted side effects, like migration of teeth, bone loss and eventually the inability to chew properly. It's far better to save your natural teeth when you can.
If you would like more information about root canals, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Common Concerns About Root Canal Treatment” and “Signs and Symptoms of a Future Root Canal.”