Posts for tag: dental injury
Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”
Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.
Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:
A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.
If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.
Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.
Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.
Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.
If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”
During his former career as a professional footballer (that's a soccer star to U.S. sports fans) David Beckham was known for his skill at “bending” a soccer ball. His ability to make the ball curve in mid-flight — to avoid a defender or score a goal — led scores of kids to try to “bend it like Beckham.” But just recently, while enjoying a vacation in Canada with his family, “Becks” tried snowboarding for the first time — and in the process, broke one of his front teeth.
Some fans worried that the missing tooth could be a “red card” for Beckham's current modeling career… but fortunately, he headed straight to the dental office as soon as he arrived back in England. Exactly what kind of treatment is needed for a broken tooth? It all depends where the break is and how badly the tooth is damaged.
For a minor crack or chip, cosmetic bonding may offer a quick and effective solution. In this procedure, a composite resin, in a color custom-made to match the tooth, is applied in liquid form and cured (hardened) with a special light. Several layers of bonding material can be applied to re-construct a larger area of missing tooth, and chips that have been saved can sometimes be reattached as well.
When more tooth structure is missing, dental veneers may be the preferred restorative option. Veneers are wafer-thin shells that are bonded to the front surface of the teeth. They can not only correct small chips or cracks, but can also improve the color, spacing, and shape of your teeth.
But if the damage exposes the soft inner pulp of the tooth, root canal treatment will be needed to save the tooth. In this procedure, the inflamed or infected pulp tissue is removed and the tooth sealed against re-infection; if a root canal is not done when needed, the tooth will have an increased risk for extraction in the future. Following a root canal, a tooth is often restored with a crown (cap), which can look good and function well for many years.
Sometimes, a tooth may be knocked completely out of its socket; or, a severely damaged tooth may need to be extracted (removed). In either situation, the best option for restoration is a dental implant. Here, a tiny screw-like device made of titanium metal is inserted into the jaw bone in a minor surgical procedure. Over time, it fuses with the living bone to form a solid anchorage. A lifelike crown is attached, which provides aesthetic appeal and full function for the replacement tooth.
So how's Beckham holding up? According to sources, “David is a trooper and didn't make a fuss. He took it all in his stride." Maybe next time he hits the slopes, he'll heed the advice of dental experts and wear a custom-made mouthguard…
If you have questions about restoring damaged teeth, please contact our office to schedule a consultation. You can read more in the Dear Doctor magazine articles “Trauma and Nerve Damage to Teeth” and “Children's Dental Concerns and Injuries.”
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.”
When a permanent tooth has been injured, our first priority should be to save it. A root canal treatment (where the interior pulp of the tooth is removed and the pulp chamber and root canals are filled and sealed) is usually the best approach for tooth preservation.
An immature permanent tooth, however, presents a different challenge. While the pulp is less essential to a mature tooth’s vitality, it serves a critical purpose in the tooth’s early development before early adulthood. The pulp produces layers of dentin necessary for the tooth’s root system development. Completely removing the pulp at this stage may retard root development and cause the tooth to eventually weaken, and become brittle and darkened.
For younger teeth, we should therefore use alternative techniques that preserve as much healthy pulp as possible. One of these alternatives is Indirect Pulp Therapy, used when the pulp hasn’t been exposed by the trauma. With this technique we remove as much damaged dentin as possible while preserving the harder dentin closer to the pulp. After applying an antibacterial agent to protect against infection, and then filling and sealing the tooth, the pulp can continue to produce dentin in a normal way.
If pulp exposure has occurred, some form of pulpotomy — the partial removal of any damaged or infected pulp — would be in order. Our goal here is to leave as much of the pulp as possible, and then apply substances that stimulate the remaining pulp to create dentin. The most common type of growth substances are calcium hydroxide or mineral trioxide aggregate (MTA).
If the pulp isn’t at all salvageable, we may then turn to a procedure known as apexification. After removing the pulp we insert MTA at the root end of the tooth, then fill and seal the remaining interior as in a regular root canal treatment. The MTA will help the surrounding bone to heal and continue to grow around the root to further support the tooth.
Recent research into pulp stem cells promises further advances in this area. The regenerative qualities of stem cells could eventually help us “engineer” root development. Until then, there are still effective ways to give a young, damaged tooth a fighting chance to survive.
If you would like more information on preserving injured teeth, 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 “Saving New Permanent Teeth After Injury.”
As America's toughest trainer on the hit television program The Biggest Loser, Jillian Michaels helped people learn that they hold the power to change. And if anyone knows about the power of changing oneself, it is Jillian Michaels. In her recent interview with Dear Doctor magazine, Jillian discusses her childhood, the trauma of being overweight as a teenager (5' 2" and 175 pounds), and the day her life forever changed when she started martial arts training at a gym. “I started training when I was 17 and always loved it but never thought it would end up being my career,” she said.
Jillian also reveals that when she was a child, she broke her two front teeth and had them repaired with crowns. She added, “Now, I generally wear a mouthguard if I am doing anything where my teeth have any chance of being knocked out.”
When it comes to replacing teeth that are broken or damaged from trauma, or teeth that are damaged because of dental decay, grinding habits, or acid erosion, crowns may be your best option. And because the tooth enamel is damaged, a bit more of it must be removed before we can place a crown. Generally speaking, we must remove about 2 millimeters of tooth structure to place a crown. Once the crown is placed, the tooth will always require a crown, as this is an irreversible procedure. However, the good news is that a crown not only mimics the look and feel of a natural tooth, but it is also the optimal long-term solution. On average, a crown last between 5 and 15 years and requires no special maintenance. In fact, you should treat your crown as you do your natural teeth, with a daily cleaning regimen of brushing and flossing and routine dental examinations and cleanings.
To learn more about crowns or other cosmetic procedures, contact us today to schedule an appointment so that we can conduct a thorough examination, discuss any questions you have as well as what treatment options will be best for you. Or to learn more about crowns now, you can continue reading the Dear Doctor magazine article “Porcelain Crowns & Veneers.” And to read the entire interview with Jillian Michaels, please see the article “Jillian Michaels.”