Although kids are resilient, they're not indestructible. They're prone to their share of injuries, both major and minor—including dental injuries.
It's common for physically active children to suffer injuries to their mouth, teeth and gums. With a little know-how, however, you can reduce their suffering and minimize any consequences to their long-term oral health.
Here are 4 types of dental injuries, and what to do if they occur.
Chipped tooth. Trauma or simply biting down on something hard can result in part of the tooth breaking off, while the rest of it remains intact. If this happens, try to retrieve and save the chipped pieces—a dentist may be able to re-bond them to the tooth. Even if you can't collect the chipped pieces, you should still see your dentist for a full examination of the tooth for any underlying injury.
Cracked tooth. A child can experience intense pain or an inability to bite or close their teeth normally if a tooth is cracked (fractured), First, call the dentist to see if you need to come in immediately or wait a day. You can also give the child something appropriate to their age for pain and to help them sleep if you're advised to wait overnight.
Displaced tooth. If a child's tooth appears loose, out of place or pushed deeper into the jaw after an accident, you should definitely see a dentist as soon as possible—all of these indicate a serious dental injury. If they're unavailable or it's after hours, your dentist may tell you to visit an emergency room for initial treatment.
Knocked-out tooth. Minutes count when a tooth is knocked completely out. Quickly locate the tooth and, holding it only by the crown and not the root, rinse off any debris with clean water. Place it in a glass of milk or attempt to place it back into the socket. If you attempt to place it back into the socket, it will require pressure to seat the tooth into position. You should then see a dentist or ER immediately.
A dental injury can be stressful for both you and your child. But following these common-sense guidelines can help you keep your wits and ensure your child gets the care they need.
During this year's baseball spring training, Minnesota Twins center fielder Byron Buxton got into a row with a steak dinner—and the beefsteak got the better of it. During his meal, the Gold Glove winner cracked a tooth.
Fortunately, he didn't lose it. Buxton's dentist rescued the tooth with a dental procedure that's been around for over a century—a root canal treatment. The dependable root canal is responsible for saving millions of teeth each year.
Dentists turn to root canal treatments for a number of reasons: a permanent tooth's roots are dissolving (a condition called resorption); chronic inflammation of the innermost tooth pulp due to repeated fillings; or a fractured or cracked tooth, like Buxton's, in which the pulp becomes exposed to bacteria.
One of the biggest reasons, though, is advanced tooth decay. Triggered by acid, a by-product of bacteria, a tooth's enamel softens and erodes, allowing decay into the underlying dentin. In its initial stages, we can often treat decay with a filling. But if the decay continues to advance, it can infect the pulp and root canals and eventually reach the bone.
Decay of this magnitude seriously jeopardizes a tooth's survival. But we can still stop it before that point with a root canal. The basic procedure is fairly straightforward. We begin first by drilling a small hole into the tooth to access the inner pulp and root canals. Using special instruments, we then remove all of the infected tissue within the tooth.
After disinfecting the now empty spaces and reshaping the root canals, we fill the tooth with a rubber-like substance called gutta percha. This, along with filling the access hole, seals the tooth's interior from future infection. In most cases, we'll return sometime later and bond a life-like crown to the tooth (as Buxton's dentist did for him) for added protection and support.
You would think such a procedure would get its own ticker tape parade. Unfortunately, there's a cultural apprehension that root canals are painful. But here's the truth—because your tooth and surrounding gums are numbed by local anesthesia, a root canal procedure doesn't hurt. Actually, if your tooth has been throbbing from tooth decay's attack on its nerves, a root canal treatment will alleviate that pain.
After some time on the disabled list, Buxton was back in the lineup in time to hit his longest homer to date at 456 feet on the Twins' Opening Day. You may not have that kind of moment after a root canal, but repairing a bothersome tooth with this important procedure will certainly get you back on your feet again.
If you would like more information about root canal therapy, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “A Step-By-Step Guide to Root Canal Treatment.”
Advances in technology often lead to greater choices for things like automobiles or smartphones. In recent decades, advances in orthodontics have given families another choice besides braces for straightening teeth: clear aligners.
Clear aligners are a series of computer-generated mouth trays of clear plastic that are custom made for an individual patient's teeth. Like braces, these trays worn in the mouth put pressure on the teeth to move in a desired direction. Patients wear an individual tray for about two weeks and then change it out for the next tray in the series. Each subsequent tray is designed to pick up where the former tray left off in the progress of tooth movement.
Although treatment takes about as along as braces, clear aligners have some distinct advantages. First and foremost, their clear plastic construction makes them nearly invisible to outside observers. This makes them ideal for appearance-conscious teens (or adults) who may be embarrassed by the look of metallic braces.
And unlike their fixed counterpart, clear aligners can be removed by the wearer for meals, hygiene and the rare special occasion. As a result, patients with aligners aren't as restricted with food items and have an easier time keeping their teeth clean and avoiding dental disease than braces wearers.
But although definitely a benefit, removability can be potentially problematic depending on the maturity level of the patient. To be effective, an aligner tray must remain in the mouth for the majority of the time—too much time out negates the effect. Patients, then, must be responsible with wearing aligners as directed.
Clear aligners may also not work for treating difficult bites, especially those that require targeted movement (or non-movement) of select teeth. In those cases, braces may be the necessary treatment. But this situation has changed in recent years with the development of new devices and techniques that increase the range of bite problems clear aligners can treat.
Depending then on the bite problem and a patient's level of personal responsibility, clear aligners can be a viable orthodontic choice. And just like braces, they too can improve both dental function and appearance.
If you would like more information on orthodontic options for teens, 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 “Clear Aligners for Teens.”
Getting dental implants is going to require surgery. But don't let that concern you—it's a relatively minor procedure.
Currently the “gold standard” for tooth replacement, an implant consists of a titanium post surgically imbedded in the jawbone. We can affix a life-like crown to a single implant or support a fixed bridge or removable denture using a series of them.
Because placement will determine the restoration's final appearance, we must carefully plan implant surgery beforehand. Our first priority is to verify that you have adequate jawbone available to support an implant.
Additionally, we want to identify any underlying structures like nerves or blood vessels that might obstruct placement. We may also develop a surgical guide, a retainer-like device placed in the mouth during surgery that identifies precisely where to create the holes or channels for the implants.
After numbing the area with local anesthesia, we begin the surgery by opening the gum tissue with a series of incisions to expose the underlying bone. If we've prepared a surgical guide, we'll place it in the mouth at this time.
We then create the channel for the insert through a series of drillings. We start with a small opening, then increase its size through subsequent drills until we've created a channel that fits the size of the intended implant.
After removing the implant from its sterile packaging, we'll directly insert it into the channel. Once in place, we may take an x-ray to verify that it's been properly placed, and adjust as needed. Unless we're attaching a temporary crown at the time of surgery (an alternate procedure called immediate loading), we suture the gums over the implant to protect it.
Similar to other dental procedures, discomfort after surgery is usually mild to moderate and manageable with pain relievers like acetaminophen or ibuprofen (if necessary, we can prescribe something stronger). We may also have you take antibiotics or use antibacterial mouthrinses for a while to prevent infection.
A few weeks later, after the bone has grown and adhered to the implant surface, you'll return to receive your new permanent crown or restoration. While the process can take a few months and a number of treatment visits, in the end you'll have new life-like teeth that could serve you well for decades.
If you would like more information on dental implants, 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.”
Tooth loss is often the unfortunate conclusion to a case of untreated periodontal (gum) disease—incentive enough to try either to prevent it or aggressively treat an infection should it occur. In either case, the objective is the same: to remove all plaque from dental surfaces.
Dental plaque (and its hardened form, tartar) is a thin buildup of bacteria and food particles on tooth surfaces. It's a ready food source for sustaining the bacteria that cause gum disease. Removing it can prevent an infection or “starve” one that has already begun.
Your first line of prevention is brushing and flossing your teeth daily to remove any accumulated plaque. Next in line are dental cleanings at least twice a year: This removes plaque and tartar that may have survived your daily hygiene.
Plaque removal is also necessary to stop an infection should it occur. Think of it as a more intense dental cleaning: We use many of the same tools and techniques, including scalers (or curettes) or ultrasonic devices to loosen plaque that is then flushed away. But we must often go deeper, to find and remove plaque deposits below the gums and around tooth roots.
This can be challenging, especially if the infection has already caused damage to these areas. For example, the junctures where tooth roots separate from the main body of the tooth, called furcations, are especially vulnerable to disease.
The results of infection around furcations (known as furcation involvements or furcation invasions) can weaken the tooth's stability. These involvements can begin as a slight groove and ultimately progress to an actual hole that passes from one end to the other (“through and through”).
To stop or attempt to reverse this damage, we must access the roots, sometimes surgically. Once we reach the area, we must remove any plaque deposits and try to stimulate regrowth of gum tissue and attachments around the tooth, as well as new bone to fill in the damage caused by the furcation involvement.
Extensive and aggressive treatment when a furcation involvement occurs—and the earlier, the better—can help save an affected tooth. But the best strategy is preventing gum disease altogether with dedicated oral hygiene and regular dental visits.
If you would like more information on preventing and treating gum disease, 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 “What are Furcations?”
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