Posts for: September, 2020
Do you remember when one of your baby teeth began to wiggle? You knew it wouldn't be long before it came out, followed by a little something from the “tooth fairy” under your pillow.
Those were the days! But a loose permanent tooth is something else entirely: Often a sign of advanced periodontal (gum) disease, you may be on the verge of losing the tooth forever.
This sad affair begins with dental plaque, a thin biofilm found on tooth surfaces and the ideal haven for oral bacteria that can trigger a gum infection. You might not notice such an infection in its early stages, other than a few initial signs like gum redness, swelling, or bleeding. If these occur, it's imperative you seek treatment promptly.
Without treatment, the infection can spread below the gum line, weakening gum attachments to teeth (which actually hold teeth in place) and eventually doing the same to underlying bone. All of this damage can lead to a tooth becoming loose and eventually falling out.
But it's not inevitable a loose tooth will eventually be lost, though it may require long-term efforts to save it. We may first need to do a bite adjustment, which will often allow a tooth to decrease its mobility. If the mobility has not been reduced enough, we may recommend stabilizing the teeth through splinting: These are techniques used to join the loose tooth to more stable teeth, usually with a thin strip of metal or other dental material.
We'll also need to treat the underlying cause, which in the case of gum disease requires aggressive plaque removal. Our goal is to manually remove all plaque and tartar (calcified plaque) deposits, particularly below the gum line. It may also require surgery to fully access deep pockets of infection. But once we remove the offending plaque, the gums can begin to heal.
The best strategy, though, is to avoid gum disease altogether. You can substantially lower your infection risk by brushing and flossing daily and getting a dental cleaning every six months. Dental visits also allow us to check your gums for any signs of infection that might require prompt action.
A loose tooth for a kid is a cause for celebration. It's the exact opposite for an adult loose tooth. Taking care of your gums with daily hygiene and receiving prompt treatment for any emerging infection could help you avoid it.
If you would like more information on 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 “When Permanent Teeth Become Loose.”
Boston Bruins defenseman Zdeno Chara had a rough Stanley Cup final against the St. Louis Blues this past June. Not only did the Bruins ultimately lose the championship, but Chara took a deflected puck shot to the face in Game Four that broke his jaw.
With the NHL season now over, the 42-year-old Bruins captain continues to mend from his injury that required extensive treatment. His experience highlights how jaw fractures and related dental damage are an unfortunate hazard in hockey—not only for pros like Chara, but also for an estimated half million U.S. amateurs, many in youth leagues.
Ice hockey isn't the only sport with this injury potential: Basketball, football (now gearing up with summer training) and even baseball players are also at risk. That's why appropriate protective gear like helmets and face shields are key to preventing injury.
For any contact sport, that protection should also include a mouthguard to absorb hard contact forces that could damage the mouth, teeth and gums. The best guards (and the most comfortable fit) are custom-made by a dentist based on impressions made of the individual's mouth.
But even with adequate protection, an injury can still happen. Here's what you should do if your child has an injury to their jaw, mouth or teeth.
Recognize signs of a broken jaw. A broken jaw can result in severe pain, swelling, difficulty speaking, numbness in the chin or lower lip or the teeth not seeming to fit together properly. You may also notice bleeding in the mouth, as well as bruising under the tongue or a cut in the ear canal resulting from jawbone movement during the fracture. Get immediate medical attention if you notice any of these signs.
Take quick action for a knocked-out tooth. A tooth knocked completely out of its socket is a severe dental injury. But you may be able to ultimately save the tooth by promptly taking the following steps: (1) find the tooth and pick it up without touching the root end, (2) rinse it off, (3) place it back in its socket with firm pressure, and (4) see a dentist as soon as possible.
Seek dental care. Besides the injuries already mentioned, you should also see a dentist for any moderate to severe trauma to the mouth, teeth and gums. Leading the list: any injury that results in tooth chipping, looseness or movement out of alignment.
Even a top athlete like Zdeno Chara isn't immune to injury. Take steps then to protect your amateur athlete from a dental or facial injury.
If you would like more information about dealing with sports-related dental injuries, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Athletic Mouthguards” and “The Field-Side Guide to Dental Injuries.”
Orthodontics, veneers and other cosmetic dental techniques can turn a less than perfect smile into a beautiful one—but not always very quickly. For example, porcelain veneers can take weeks from planning to installation, including the meticulous work of an outside dental lab to produce veneers that look natural as well as beautiful.
But you may be able to take advantage of another approach, one that often takes no more than a couple of dental visits. Called direct veneers, it's actually a process of bonding and sculpting life-like composite materials to teeth that are heavily stained, chipped or that contain tiny crevices called “craze lines.”
Unlike the similarly-named traditional method, direct veneers don't involve the creation of layered porcelain veneers fashioned by a dental lab. But this newer process is similar to the older one in that some of the enamel must be removed from the teeth in question to provide a suitable surface for the composite material to adhere. This alteration will be permanent, requiring a restorative covering on the treated teeth from then on.
Right before this preparation, though, a dentist typically makes an impression of the patient's mouth. This will be the basis for creating the procedural plan for the dental work, particularly a “trial smile” from similar composite material that can be applied to the patient's teeth before actual restoration work begins. This temporary application gives both patient and dentist an opportunity to visualize the final look, and make needed adjustments in color and shaping.
Once the work plan is finalized, the patient then returns for the actual restoration procedure. The dentist begins by applying and bonding the composite material to the prepared teeth. Then, using a drill and manual instruments, the dentist shapes and smooths the material into a tooth-like appearance that blends with other teeth. The procedure can take a few hours, but it can usually be completed during a single visit.
Although direct veneers may not last as long as porcelain veneers, the process is less costly and requires less time to complete. Direct veneers could be an economical solution for achieving a more attractive smile.
If you would like more information on direct veneers, please contact us or schedule an appointment for a consultation. You can also learn more about this topic with a firsthand patient account by reading the Dear Doctor magazine article “A New Smile With Direct Veneers.”