Posts for: September, 2014
Everyone knows that football players and boxers wear mouthguards to protect their teeth from injury — in fact, it's thought that this essential piece of protective gear was first developed, around a century ago, for the latter sport. But did you know that many other athletic activities carry a high risk of dental injury?
How much do you know about dental injuries in sports? Take this quiz and find out!
True or False: Of all sports, baseball and basketball are associated with the largest number of dental injuries.
True. While these games aren't categorized as “collision” sports, the damage caused by a flying elbow or a foul ball may be quite traumatic. Tooth damage or loss can create not only esthetic problems, but also functional problems, like difficulty with the bite. Missing teeth can also be expensive to fix — running up a lifetime tab of some $10,000 - 20,000 if they canâ??t be properly preserved or replanted.
True or False: In general, oral-facial injuries from sports decline from the teen years onward.
True. Sports-related dental injuries, like other trials of adolescence, seem to peak around the teenage years. It's thought that the increased skill level of participants in the older age groups reduces the overall incidence of injury. But there's a catch: when dental injuries do occur in mature athletes, they tend to be more serious. So, protecting your teeth while playing sports is important at any age.
True or False: Over 80% of all dental injuries involve the upper front teeth.
True. For one thing, the front teeth areâ?¦ in front, where they can easily come in contact with stray objects. An individual's particular anatomy also plays a role: The more the front teeth “stick out” (referred to as “overjet” in dental parlance), the more potential for injury. In any case, theyâ??re the most likely to be damaged, and most in need of protection.
True or False: Your chance of receiving a dental injury in non-contact sports is very slim.
False. Even “non-contact” athletes moving at high rates of speed can be subject to serious accidents. Activities like bicycling, motocross, skateboarding, skiing and snowboarding all carry a risk. The accidents that result can be some of the most complicated and severe.
True or False: An athlete who doesn't wear a mouthguard is 60 times more likely to suffer harm to the teeth.
True. This figure comes straight from the American Dental Association. So if you want to reduce your chance of a sports-related dental injury, you know what to do: Wear a mouthguard!
What's the best kind of mouthguard? Like any piece of sports equipment, it's the one that's custom-fitted just for you. We can fabricate a mouthguard, based on a precise model of your teeth, that's tough, durable and offers the best level of protection. And, as many studies have shown, that's something you just can't get from an off-the-shelf model.
If you have concerns about sports-related dental injuries and their prevention, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”
By the time you reach adulthood, roughly 100 trillion microscopic organisms will have taken up residence in and on your body, outnumbering your own cells 10 to 1. Most are bacteria, a domain of the animal kingdom considered synonymous with disease. But only a few of the thousands of bacterial species cause us harm; the rest are either benign or actually beneficial to our health, including in our mouths.
Dentistry pioneered much of our knowledge about bacteria, developing processes used to identify, classify and understand those species inhabiting our mouths. Science as a whole is catching up with the Human Microbiome Project (HMP) begun in 2007. Through HMP, researchers have catalogued and begun to study more than 10,000 bacterial species.
We’re finding that our bodies develop a symbiotic relationship with many of these creatures invisible to the naked eye. During our infancy the bacteria we ingest from birth and breast feeding begin to interact with our body’s immune system, “teaching” it to refrain from attacking friendly organisms that contribute to health and searching and destroying enemy species that cause disease.
We’re also learning that an imbalance with our individual population of bacteria has links with disease. Our digestive system is a prime example: bacteria related to obesity can overpopulate our digestive tract, while malnutrition can create an environment that produces too many bacteria that inhibit digestion of vitamins and other nutrients.
The same microbial imbalance can occur in the mouth. For example, our typical Western diet encourages the growth of bacteria most associated with tooth decay (Streptococcus mutans). We’re also finding that tobacco smoking creates a mouth environment more conducive to the bacteria that cause gum disease. Just by quitting smoking you can alter that environment to encourage growth of health-promoting bacteria and inhibit growth of malevolent species.
The desired outcome of this knowledge is to develop treatments that target disease-causing bacteria without harming those beneficial to us (as often occurs with traditional antibiotics). In dentistry, such possibilities could help stop the spread of tooth decay, gum disease or similar bacterial infections, while fostering a healthier oral environment that prevents disease and protects health.
Our “baby” teeth begin appearing around six months of age — by age 10 or 13, they’ve largely been replaced by our permanent teeth. Though their lifespan is relatively short, baby teeth play an important role in our dental development. In fact, saving a damaged baby tooth is an extremely important treatment goal even though they will be eventually lost.
Baby teeth perform a number of functions as our mouth and facial structure develops during our formative years (infancy to early adulthood). Besides providing a means to chew food, baby teeth aid speech by providing contact points for the tongue while speaking. They help us relate to others socially through smiling and other facial gestures. And, in relation to our long-term development, they serve as both guides and “placeholders” for our permanent teeth until they’re ready to erupt.
Thus, a permanent tooth’s development could be stymied if its counterpart baby tooth is lost prematurely. It could come in misaligned or not erupt fully if adjacent teeth have drifted into the open space. The resulting malocclusion (bad bite) could require long-term orthodontic treatment with higher costs than treatments to save the baby tooth and avoid the misalignment.
There are various treatments to prevent and save at-risk baby teeth. Even a badly decayed tooth might be saved with a pulpotomy, a similar treatment to a root canal but less invasive. This is often followed with a stainless steel crown to cover the remaining tooth and restore some of its form and function.
If it’s not feasible to save a baby tooth, we may recommend installing a space maintainer that prevents other teeth from drifting into the resulting space until the permanent tooth is ready to erupt. This orthodontic appliance usually consists of a metal band cemented to an adjacent tooth with an attached stiff wire loop that extends across the gap and rests against the tooth on the other side. Although effective, space maintainers can break or become dislodged, require extra monitoring and are often cosmetically unappealing.
In any event, the primary goal should be to save a baby tooth, if possible. Doing so will prevent more serious long-term problems for permanent teeth.
Treating periodontal (gum) disease is rather straightforward: remove the bacterial plaque that causes the disease. The techniques to accomplish this are varied, depending on how far the disease has advanced with an individual patient.
Plaque is a thin film of bacteria and food particles that build up on tooth surfaces due to inadequate oral hygiene. The bacteria that grow there can cause an infection that inflames and damages the gum and supporting bone tissues to the point they begin to lose their attachment to the teeth and form spaces known as periodontal pockets. In time, plaque becomes calcified due to the minerals in saliva, forming calculus or tartar. As the disease advances, it can ultimately cause tooth loss.
The most common technique for interrupting this progression of disease is known as scaling. Using hand instruments and/or an ultrasonic device, we remove as much plaque and calculus as we can detect on the outer surfaces of the teeth and gum tissues. Scaling, however, won’t address the plaque and calculus that has accumulated at the tooth root level, especially where pocket formation has taken place. This is where root planing may be necessary.
As the name implies, we use this procedure to literally “plane” plaque and calculus from the roots, a similar concept to removing thin layers of wood from a board. If necessary, we will first numb the affected area so that we can perform the procedure in a meticulous manner without causing discomfort. It’s essential we remove every bit of plaque and calculus that we can, especially where it has become lodged deep at the base of the pockets.
It’s common to start with ultrasonic therapy, using vibration to loosen the plaque while flushing the pockets with water. We then switch to delicate hand instruments known as curettes to physically remove any remaining plaque and calculus. An experienced touch helps us determine when the root surfaces have been properly cleaned; we can also “read the gum tissues,” as they will slightly change color as the offending plaque and calculus deposits are removed. As the gum tissues heal and become less inflamed, they return to a healthy pink color and the pocket depths generally become smaller as the inflammation leaves the area.
While a good portion of the treatment requires our professional skills, equipment and expertise, the bedrock for renewed periodontal health is effective daily oral hygiene on your part. Working together we can preserve the progress already made, while continuing to progress in restoring your oral health.
If you would like more information on root planing and other periodontal disease treatments, 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 “Root Planing.”
Tooth decay (dental caries) is one of the world’s most common infectious diseases. Left untreated, it can lead to tooth loss. The best treatment strategy, of course, is to prevent it from occurring in the first place with a long-term approach that begins in early childhood and continues throughout our lifetime.
Here are some basic components for just such a prevention strategy.
Know your risk. We each don’t share the same level of risk for tooth decay, so it’s important to come to terms with any factors that raise your personal risk for the disease — your dental history, inadequate oral hygiene, absence of fluoride use, and lifestyle habits like smoking. Coming to terms with these and other factors — and altering those you can change — can lower your risk.
Reduce acid-producing bacteria in your mouth. Tooth decay usually arises from elevated acidic levels in the mouth caused by certain strains of oral bacteria. You can reduce these bacteria by removing plaque, a thin film of food particles that collect on tooth surfaces, with daily oral hygiene and regular cleanings in our office. In some cases, we may also recommend antibacterial mouthrinses like chlorhexidine to further lower the bacterial population.
Apply protective measures to teeth. Fluoride, a naturally occurring chemical, has been proven effective in strengthening tooth enamel and reducing tooth decay. In addition to fluoride found in many oral hygiene products and public water systems, children can also benefit from a direct application of fluoride to the enamel surface just after the teeth have erupted in the mouth. Many clinical studies have shown 99% cavity free results in over a thousand teeth receiving a fluoride application with sealants.
Control your diet. Bacteria ferment leftover sugars and other carbohydrates in the mouth; this creates acid, which can soften tooth enamel and lead to decay. You can limit this effect by eating more fresh fruits and vegetables and reducing your consumption of refined sugar. You should also limit between meal snacking — constant snacking prevents saliva, the mouth’s natural acid neutralizer, from effectively restoring the mouth’s pH balance.
A prevention strategy for tooth decay will help you avoid unnecessary pain and problems — physically and financially. You’ll also reap the rewards that come from a lifetime of good dental health.
If you would like more information on preventing tooth decay, 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 “Tooth Decay.”