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.”
Although teeth are quite durable, we can still lose them—even all of them—to disease or injury. The good news, though, is that we have effective ways to restore teeth after they're lost. One of these, the removable denture, has given people their teeth back for several generations. And with recent advances in technology, today's dentures are even better.
Although more advanced, today's dentures share the same basic structure as those from a century ago: prosthetic (false) teeth set in a plastic resin colored to resemble the gums. The traditional denture is molded to fit snugly over an individual patient's alveolar jaw ridges, which once supported the former natural teeth. The denture stays in place primarily through a suction effect between the denture and the ridges.
Modern technology, though, has greatly improved today's dentures. Digital imaging can be used to generate highly accurate impressions of the dental ridges that can lead to denture bases with better fit. Dentists using photographs of the patient, especially in earlier years, are better able to identify facial landmarks, which enables them to position the new teeth to more closely recreate the patient's former smile.
These technological aids now help dentists to create more attractive dentures with better support and comfort. But the fit that makes this possible may not last due to a particular weakness inherent in traditional dentures—continuing bone loss. When teeth are missing, the underlying jawbone can lose bone volume over time. Dentures don't stop this process and can accelerate it due to constant friction and pressure on the dental ridges.
But a new modification incorporating dental implants with dentures can help solve these problems. By placing a few strategically positioned implants in the jawbone that then connect with the denture, the appliance not only gains more stability, but also produces less pressure on the dental ridges. In addition, bone cells naturally grow and adhere to the titanium implant posts, which helps to stop or slow bone loss.
If you've experienced total tooth loss, dentures are an affordable and effective option. Thanks to modern dental advances, you can get back the smile and dental function you once lost.
If you would like more information on denture restorations, 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 “Removable Full Dentures.”
According to Forbes Magazine, Kylie Jenner is the world's youngest billionaire at age 22. Daughter of Caitlyn (Bruce) Jenner and Kris Jenner, Kylie is the founder and owner of the highly successful Kylie Cosmetics, and a rising celebrity in her own right. But even this busy CEO couldn't avoid an experience many young people her age go through each year: having her wisdom teeth removed.
At around 10 million removals each year, wisdom teeth extraction is the most common surgical procedure performed by oral surgeons. Also called the third molars, the wisdom teeth are in the back corners of the jaws, top and bottom. Most people have four of them, but some have more, some have fewer, and some never have any. They're typically the last permanent teeth to come in, usually between ages 17 and 25.
And therein lies the problem with wisdom teeth: Many times, they're coming in late on a jaw already crowded with teeth. Their eruption can cause these other teeth to move out of normal alignment, or the wisdom teeth themselves may not fully erupt and remain fully or partially within the gums (a condition called impaction). All of this can have a ripple effect, decreasing dental function and increasing disease risk.
As Kylie Jenner has just experienced, they're often removed when problems with bite or instances of diseases like tooth decay or gum disease begin to show. But not just when problems show: It's also been a common practice to remove them earlier in a kind of “preemptive strike” against dental dysfunction. But this practice of early wisdom teeth extraction has its critics. The main contention is that early extractions aren't really necessary from a medical or dental standpoint, and so patients are unduly exposed to surgical risks. Although negative outcomes are very rare, any surgical procedure carries some risk.
Over the last few years, a kind of middle ground consensus has developed among dentists on how to deal with wisdom teeth in younger patients. What has emerged is a “watch and wait” approach: Don't advise extraction unless there is clear evidence of developing problems. Instead, continue to monitor a young patient's dental development to see that it's progressing normally.
Taking this approach can lead to fewer early wisdom teeth extractions, which are postponed to a later time or even indefinitely. The key is to always do what's best for a patient's current development and future dental health.
Still, removing wisdom teeth remains a sound practice when necessary. Whether for a high school or college student or the CEO of a large company, wisdom teeth extraction can boost overall dental health and development.
If you would like more information about wisdom teeth and their impact on dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Wisdom Teeth: To Be or Not to Be?”
As the old Fifties song goes, “Little things mean a lot.” They can also be the most irritating, like a hangnail, a papercut—or a certain kind of oral sore. Although rarely concerning to health, this particular kind of “bump” in the mouth can be unnerving.
Although known as a traumatic fibroma, it's not as dire as it sounds: It's simply a small wound created when your inside cheek gets in the “line of fire” between your teeth while biting or chewing. It's an experience most of us have had, and though it's a minor occurrence, it can make us wince with pain.
But the pain usually lasts only a few seconds—until the next time, which is a distinct possibility. The body creates a protective callous over the wound made of fibers (hence the name fibroma) of a protein called collagen. This creates a rise in the skin surface that increases the chances the area will again get in the way of the teeth and be bitten. Each bite leads to another layer of collagen, a more prominent rise and even greater probability of another bite.
Rather than let this irritating situation repeat itself, you can undergo a minor surgical procedure to remove the fibroma. Usually performed be an oral surgeon or periodontist, the area is numbed first with a local anesthetic and the fibroma removed with a scalpel; the resulting wound is then closed with a few stitches or a laser, in which case no stitches are necessary. As a result, the cheek surface flattens out and becomes less likely to get in between the teeth.
The dentist may also preserve some of the removed tissue and submit it for a biopsy to check for any cancer cells or other abnormalities. You shouldn't be concerned about this: Examining excised tissue is a routine step performed for a variety of surgical procedures. It's used to verify the tissue in question is benign, which in this case is the vast majority of the time.
After the procedure, you might experience some minor discomfort for a few days, usually manageable with a mild pain reliever like aspirin or ibuprofen. The procedure itself only takes about fifteen minutes, but it can provide you lasting relief from that bedeviling little sore in your mouth.
If you would like more information on treating mouth sores, 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 “Common Lumps and Bumps in the Mouth.”
It's normal for people to breathe through their nose. And for good reason: Nasal breathing filters contaminants, warms and humidifies incoming air, and helps generate beneficial nitric oxide. Chronic mouth breathing, on the other hand, can trigger a number of harmful effects, especially for the teeth and gums.
Because our survival depends on continuous respiration, our bodies automatically seek out the air flow path of least resistance, normally through the nose. But if our nasal passages become obstructed, as with enlarged adenoids or sinus congestion, we may involuntarily breathe through the mouth.
This can lead to oral problems like chronic dry mouth, which not only creates an unpleasant mouth feel, it also produces the ideal environment for dental disease. And, it could cause an even more serious problem for children during jaw and teeth development.
This is because the tongue rests along the roof of the mouth (palate) while breathing through the nose. In this position, the tongue serves as a mold for the upper jaw and teeth while they're growing during childhood. During mouth breathing, however, the tongue moves away from the palate, depriving the jaw and teeth of this molding effect, and possibly resulting in a poor bite.
You can prevent these and other oral problems by seeing a healthcare professional as soon as you notice your child regularly breathing through their mouth. The best professional for this is an ENT, a medical specialist for conditions involving the ears, nose and throat. ENTs provide treatment for diagnosed obstructions involving the tonsils, adenoids and sinuses.
Even so, persistent mouth breathing may already have affected your child's bite. It may be prudent, then, to also have their bite evaluated by an orthodontist. There are interventional measures that can help get jaw development back on track and minimize future orthodontic treatment.
Finally, a child who has undergone treatment to remove nasal breathing obstructions usually reverts to nasal breathing automatically. But sometimes not: To “relearn” normal breathing, a child may need to undergo orofacial myofunctional therapy (OMT) with a certified therapist to retrain their facial muscles and tendons to breathe through the nose.
Your child's tendency to mouth breathing may not seem like a major problem. But prompt attention and treatment could prevent it from interrupting their dental development.
If you would like more information on correcting mouth breathing, 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 Trouble With Mouth Breathing.”
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