Posts for category: Oral Health
For anyone else, having a tooth accidentally knocked out while practicing a dance routine would be a very big deal. But not for Dancing With The Stars contestant Noah Galloway. Galloway, an Iraq War veteran and a double amputee, took a kick to the face from his partner during a recent practice session, which knocked out a front tooth. As his horrified partner looked on, Galloway picked the missing tooth up from the floor, rinsed out his mouth, and quickly assessed his injury. “No big deal,” he told a cameraman capturing the scene.
Of course, not everyone would have the training — or the presence of mind — to do what Galloway did in that situation. But if you’re facing a serious dental trauma, such as a knocked out tooth, minutes count. Would you know what to do under those circumstances? Here’s a basic guide.
If a permanent tooth is completely knocked out of its socket, you need to act quickly. Once the injured person is stable, recover the tooth and gently clean it with water — but avoid grasping it by its roots! Next, if possible, place the tooth back in its socket in the jaw, making sure it is facing the correct way. Hold it in place with a damp cloth or gauze, and rush to the dental office, or to the emergency room if it’s after hours or if there appear to be other injuries.
If it isn’t possible to put the tooth back, you can place it between the cheek and gum, or in a plastic bag with the patient’s saliva, or in the special tooth-preserving liquid found in some first-aid kits. Either way, the sooner medical attention is received, the better the chances that the tooth can be saved.
When a tooth is loosened or displaced but not knocked out, you should receive dental attention within six hours of the accident. In the meantime, you can rinse the mouth with water and take over-the-counter anti-inflammatory medication (such as ibuprofen) to ease pain. A cold pack temporarily applied to the outside of the face can also help relieve discomfort.
When teeth are broken or chipped, you have up to 12 hours to get dental treatment.Â Follow the guidelines above for pain relief, but don’t forget to come in to the office even if the pain isn’t severe. Of course, if you experience bleeding that can’t be controlled after five minutes, dizziness, loss of consciousness or intense pain, seek emergency medical help right away.
And as for Noah Galloway:Â In an interview a few days later, he showed off his new smile, with the temporary bridge his dentist provided… and he even continued to dance with the same partner!
If you would like more information about dental trauma, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Trauma & Nerve Damage to Teeth” and “The Field-Side Guide to Dental Injuries.”
Besides attractively showcasing your teeth, your gums protect your teeth and underlying bone from bacteria and abrasive food particles. Sometimes, though, the gums can pull back or recede from the teeth, leaving them exposed and vulnerable to damage and disease.
Here are 4 things that could contribute to gum recession—and what you can do about them.
Periodontal (gum) disease. This family of aggressive gum infections is by far the most common cause for recession. Triggered mainly by bacterial plaque, gum disease can cause the gums to detach and then recede from the teeth. To prevent gum disease, you should practice daily brushing and flossing and see your dentist at least twice a year to thoroughly remove plaque. And see your dentist as soon as possible for diagnosis and treatment at the first sign of red, swollen or bleeding gums.
Tooth position. While a tooth normally erupts surrounded by bone, sometimes it erupts out of correct alignment and is therefore outside the bony housing and protective gum tissue. Orthodontic treatment to move teeth to better positions can correct this problem, as well as stimulate the gum tissues around the involved teeth to thicken and become more resistant to recession.
Thin gum tissues. Thin gum tissues, a quality you inherit from your parents, are more susceptible to wear and tear and so more likely to recede. If you have thin gum tissues you'll need to stay on high alert for any signs of disease or problems. And you should also be mindful of our next common cause, which is….
Overaggressive hygiene. While it seems counterintuitive, brushing doesn't require a lot of "elbow grease" to remove plaque. A gentle scrubbing motion over all your tooth surfaces is usually sufficient. On the other hand, applying too much force (or brushing too often) can damage your gums over time and cause them to recede. And as we alluded to before, this is especially problematic for people with thinner gum tissues. So brush gently but thoroughly to protect your gums.
If you would like more information on treating gum recession, 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 “Gum Recession.”
Like other healthcare providers, your dentist keeps records of your ongoing care. These include not only their written notes but also x-ray imaging, frequency of visits and cleanings, and any medical information that could affect your care. What’s more, they have a legal obligation to maintain these records.
Your dental records help guide decisions about your care. In that regard, you should consider something else—you may need to change providers: your dentist retires or you move; your dentist isn’t in your new insurance network; or, unfortunately, you have an “irreconcilable” difference with your provider.
If that happens, it’s very important your dental records find their way to your new provider. Here are 3 reasons why.
Your individual dental history. Each person’s dental situation and needs are unique. Your past records help clue in your new dentist about your past history and current needs, which will help guide how they treat you.
Time and money. Your dental records contain x-rays or other diagnostic information about your oral condition, including preparations for any upcoming dental work. If you change dentists before completing that treatment, your new dentist may have to start over with new diagnostic tests if they don’t have this previous data. It could cost you more money and make you wait longer for a needed procedure.
Coordinating dental care with your general health. Your mouth isn’t isolated from the rest of your body, and some dental treatment measures could affect other health conditions (and vice-versa). If your new dentist knows other health issues you may have from your previous records, it can help ensure you’re getting dental treatment appropriate to your overall health.
For the most streamlined transition between providers, it’s important your dental records follow you. You’re entitled to having those records transferred, and, if you’re uncomfortable asking yourself, your new provider can obtain them for you. Just be sure to ask.
If you would like more information on your rights regarding your dental care records, 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 “Why Your Dental Records Should Follow You.”
Around 20 million people—mostly women after menopause—take medication to slow the progress of osteoporosis, a debilitating disease that weakens bones. But although effective, some osteoporosis drugs could pose dental issues related to the jawbones.
Osteoporosis causes the natural spaces that lie between the mineral content of bone to grow larger over time. This makes the bone weaker and unable to withstand forces it once could, which significantly increases the risk of fracture. A number of drugs have been developed over time that stop or slow this disease process.
Two of the most prominent osteoporosis drugs are alendronate, known also by its trade name Fosamax, and denosumab or Prolia. While originating from different drug families, alendronate and denosumab work in a similar way by destroying specialized bone cells called osteoclasts that break down worn out bone and help dissolve it. By reducing the number of these cells, more of the older bone that would have been phased out lasts longer.
In actuality this only offers a short-term benefit in controlling osteoporosis. The older bone isn’t renewed but only preserved, and will eventually become fragile and more prone to fracture. After several years the tide turns negatively for the bone’s overall health. It’s also possible, although rare, that the bone simply dies in a condition called osteonecrosis.
The jawbones are especially susceptible to osteonecrosis. Forces generated by chewing normally help stimulate jawbone growth, but the medications in question can inhibit that stimulus. As a result the jawbone can diminish and weaken, making eventual tooth loss a real possibility.
Osteonecrosis is most often triggered by trauma or invasive dental procedures like tooth extractions or oral surgery. For this reason if you’re taking either alendronate and denosumab and are about to undergo a dental procedure other than routine cleaning, filling or crown-work, you should speak to your physician about suspending your medication temporarily. Dentists often recommend a suspension of three to nine months before the procedure and three months afterward.
Some research indicates this won’t worsen your osteoporosis symptoms, especially if you substitute another treatment or fortify your skeletal system with calcium and vitamin D supplements. But taking this temporary measure could help protect your teeth in the long run.
If you would like more information on the effect of osteoporosis treatment on dental health, 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 “Osteoporosis Drugs & Dental Treatment.”
It’s been a long road with your braces, but now they’re finally off. Hopefully the first glimpse of your new smile more than made up for the time and effort they required.
But while braces removal is a big milestone, it’s not the end of your treatment—not, that is, if you want to keep that new smile! You’ll now need to wear an appliance called a retainer for a few years or, in some cases, from now on.
Orthodontic retainers are a must after braces for the same reason braces work in the first place—your teeth can move. While the teeth attach to the jawbone via the roots, they’re firmly held in place by an elastic gum tissue network called the periodontal ligament. This tough but elastic tissue lies between the teeth and gums and attaches securely to both with tiny fibers.
While the ligament provides stability, it’s also dynamic—constantly remodeling to allow the teeth to move in response to biting pressure and other mouth factors. Orthodontists use this mechanism when moving teeth to better positions. The braces apply pressure on the teeth in the desired direction and the periodontal ligament responds as the teeth move.
Afterward, however, the ligament can still retain a kind of “muscle memory” for a time of the teeth’s old positions. Free of the pressure once supplied by the braces the teeth have a tendency, especially early on, to “rebound” to where they were.
A retainer helps prevent this by exerting just enough pressure to “retain” the teeth in their new positions. In the beginning this may require wearing the appliance around the clock, but you may be able later to reduce wear time to just a few hours a day. Rebounding is unpredictable, so you should continue to follow your orthodontist’s recommendations on retainer wear.
Wearing a retainer may seem like a drag, but it’s absolutely essential. Being diligent about it will help ensure that the beautiful smile you and your orthodontist worked so hard to obtain stays with you for years to come.
If you would like more information on getting a new smile through orthodontics, 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 Importance of Orthodontic Retainers.”