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.”
After ruling out other possibilities for your constant jaw joint pain, your doctor has diagnosed you with a temporomandibular disorder (TMD). Now that you know what you have, what can you do about it?
Unfortunately, it's not always an easy answer. Ideas about treatment are almost as numerous as theories on the causes of TMD. By and large, though, we can classify treatment into two broad categories: conservative and aggressive.
The conservative approach is the result of many years of experimentation and application; it's also much less invasive than aggressive treatments. For most patients, though, these treatments can offer significant relief from pain and dysfunction.
Conservative treatments are based primarily on the philosophy that the temporomandibular joint is like any other joint, and should be treated that way. Treatments include thermal therapies like ice or heat packs applied to the jaw, physical therapy (gentle stretching, jaw exercise, and massage) and pain and muscle relaxant medication. In cases where teeth grinding may be a contributing factor, we might recommend a bite guard worn in the mouth to reduce biting pressure.
On the other end of the spectrum are treatments like altering the bite or the position of the jaw. The purpose of bite alteration is to change the dynamic when the jaws are in contact during chewing or clenching, and reduce pressure on the joints. This is often done by reshaping the teeth's biting surfaces, moving the teeth with orthodontics or performing crown and bridgework. Another possibility, actually modifying the lower jaw location, requires surgery. All of these aggressive treatments are done in order of less to more invasiveness.
These more aggressive treatments, especially jaw surgery, are irreversible. Furthermore, studies on results have not been encouraging — there's no guarantee you'll receive relief from your symptoms. You should consider the aggressive approach only as a last resort, after you've tried more conservative measures. Even then, you should get a second opinion before undergoing more invasive procedures.
Hopefully, you'll see relief from therapies that have made a significant difference for most TMD sufferers. And that's our goal: to reduce your pain and dysfunction and help you regain your quality of life.
If you would like more information on TMD causes and treatments, 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 “Seeking Relief from TMD.”
If you’re facing cancer treatment, we wish you the best outcome possible. Treating this disease has advanced tremendously in recent decades, but the available options are still often challenging to endure. It will be your primary focus for the foreseeable future.
As a dental provider we also want you to be aware how the two main treatments, chemotherapy and radiation, could adversely affect your teeth and gums, especially if you’re receiving radiation therapy near the head and neck. The aim of cancer treatment is to attack and destroy cancer cells to prevent their growth. Unfortunately, it can also destroy neighboring healthy cells and lead to harmful consequences in different parts of the body, including the mouth.
Salivary glands, for example, are especially vulnerable to damage during cancer treatment. This could create a situation where the mouth no longer produces adequate saliva flow, leading to a condition called xerostomia or dry mouth. Besides a lot of discomfort, restricted saliva flow can also increase your risk of tooth decay and other dental diseases. This is because saliva is the body’s acid neutralizer (acid can erode tooth enamel) and its first line of defense against microbial infection.
To guard against this, it’s important to support salivary flow as much as possible if you experience dry mouth symptoms during treatment (as well as beyond—it’s possible the damage to these glands could be permanent). Since some medications also contribute to dry mouth, you should speak with your physician about the prescriptions you’re taking: if any have dry mouth side effects ask if there’s an alternative drug without these side effects. You should also drink more water during the day and especially when taking medications. And consider substances like xylitol gum that can help boost saliva flow.
Unfortunately, it may not be possible to fully avoid the effects of these treatments on your teeth and gums. So, be sure you keep up daily brushing and flossing and see your dentist regularly for cleanings and checkups. If necessary, there are a number of restoration options to restore your smile after you’ve completed your treatment.
March is national nutrition month—a good time to look at the connection between diet and oral health. You probably know that sugar is a major culprit in dental problems. This is because bacteria feed on sugars and create acid that can lead to tooth decay and gum disease. Avoiding sugary foods and drinks as much as possible is a good rule of thumb, but there are some food choices that actually benefit your oral health. Here are nutrition tips that will help keep your smile healthy for life:
Say cheese. Dairy products such as milk, cheese and yogurt contain calcium and phosphorus to build teeth and strengthen the supporting bone. And cheese neutralizes acid in the mouth to help fight cavities and gum disease.
Choose lean proteins. Lean meats, poultry, fish, milk and eggs help strengthen teeth. They are rich in protein and phosphorous, which is essential for building strong bones and teeth.
Eat a rainbow. Fruits and vegetables provide many key nutrients, including vitamins necessary for healing, bone strength, and healthy gums. Besides being nutritious, fruits and veggies scrub your teeth while you chew and stimulate the production of saliva, which is necessary for neutralizing acid and rebuilding enamel.
Nibble on nuts. Nuts contain protein, fiber and healthy fats. They also contain essential vitamins and minerals to keep teeth strong and gums healthy. Further, chewing nuts stimulates saliva production, lowering the risk of tooth decay.
Go for the grains. Studies have shown that eating too many refined carbohydrates such as white bread and sweet bakery items can lead to chronic inflammation, which is a factor in gum disease, heart disease, stroke and other conditions. In contrast, eating complex carbohydrates such as whole grains may reduce inflammation in the body.
What you put in your body can play a big role in preventing tooth decay and gum disease, so choose foods that provide the right building blocks for optimal dental and overall health.
As a member of the best-selling pop group Spice Girls, Mel C (AKA Sporty Spice) enjoyed her share of musical superstardom. At the band’s peak in the Nineties, the young singer’s signature look featured baggy sweatpants, an assortment of tattoos, a nose stud and a gold-capped incisor, front and center in her mouth. Today, Melanie Chisholm is still singing — but now she’s a mom, an amateur triathlete… and that gold tooth is just a memory. Not only that, her smile looks more evenly spaced and whiter than it did when she was referred to as the “tomboy” of the group.
What happened? In our view, it all boils down to changing tastes — plus a little bit of help from dental professionals. As the “wannabe” singer proves, there’s no single standard when it comes to making your teeth look their best. Your own look is unique to you — and your smile can reflect that individuality.
For example, crowns (caps) are substantial coverings that may be placed on teeth when they are being restored. They are available in three types: gold, all-porcelain, or porcelain-fused-to-metal. The latter two are tooth-colored, while the gold is — well, shiny like gold bling. Which one is right for you? In many cases, it’s your choice.
Likewise, dental veneers — wafer-thin shells that can correct cosmetic issues by covering the surface of your teeth — can be made in a variety of shades. Their hues may range from natural ivory to Hollywood white, and everything in between. What’s the best color for you? Only you can say.
Some people opt for a “smile makeover” that uses small irregularities in the spacing and color of teeth to create a more “natural” look. Other folks want a perfectly even, brilliant white smile that dazzles the eye. Still others are looking to match or restore the smile they once had — perhaps even re-creating a signature gap between the teeth. As long as there are no other dental issues involved, the choice is yours.
So if you’re unhappy with your smile — or if you feel it doesn’t reflect the person you “wannabe” — why not talk to us about a smile makeover? Just call our office to schedule a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Impact of a Smile Makeover.”
Whatever problems you may have with your teeth and gums, there are effective solutions in modern dentistry. But like other aspects of healthcare, dental treatment can be quite costly. For many it isn't what can be done but what they can afford to have done.
If you too have limited financial means, don't lose hope — there are effective ways to manage your dental care, especially with a little planning ahead.
The most important thing you can do to manage dental costs is to prevent disease through consistent oral hygiene — brushing and flossing — at least once a day. Removing bacterial plaque, a film of leftover food particles that can trigger infection, from your teeth will significantly lower your risk of tooth decay and periodontal (gum) disease, two very common sources of dental care costs.
It's also important that you visit the dentist at least twice a year. Although it's an expense, it's worth budgeting because it could, along with daily hygiene, save you money in the future. During these visits we'll remove plaque and calculus (hardened plaque deposits) from hard to reach places you might have missed. We'll also check for developing problems: the earlier they're detected the less the long-term impact on your finances.
We'll also evaluate your individual risk factors for dental disease. Some, like hereditary factors, we can't control. But others, like diet and lifestyle choices, we can alter to significantly lower your chance of disease.
With this risk factor profile, we can then put together an ongoing treatment strategy. Not only will this help prevent or at least reduce problems with your teeth and gums, it will help reduce costs in the long run.
Unfortunately, even with the best efforts we can't altogether rule out problems. We'll need to treat those that arise, and usually the sooner the better. Even so, we can usually take your financial situation into account, such as a less expensive temporary measure until you can afford a more permanent solution. We also have payment programs that can help you manage costs as well.
The important thing is not to delay regular dental checkups. The sooner you begin quality dental care the less of an impact any problems we find will pose to your dental health and your wallet.
If you would like more information on financial management for your dental care, 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 “Cost-Saving Treatment Alternatives.”
If you're considering dental implants, they'll need to be surgically placed in the jaw bone. But don't be alarmed — it's a relatively minor procedure that usually requires nothing more than local anesthesia.
But that being said, it's still an invasive procedure that involves making incisions in gum and bone tissues. That could introduce bacteria into the bloodstream and pose, for certain individuals, a slightly greater risk of infection.
But infection risk is quite low for most healthy patients. As a result, implants enjoy a greater than 95-percent success rate ten years after installation. But some patients have health issues that increase their risk of infection. These include older adults with a weakened immune system, smokers, diabetics or those well under or over their ideal weight.
If you have these or similar health situations, we may recommend undergoing an antibiotic treatment before you undergo surgery. This can help prevent bacteria from spreading and reduce the likelihood of an infection.
Preventive antibiotic therapy is commonplace with many other dental procedures. Both the American Dental Association and the American Heart Association recommend antibiotics before any invasive oral procedure for patients with prosthetic (false) heart valves, past endocarditis, a heart transplant or other heart conditions. To lower the risk of implant failure due to infection, we often advise antibiotics for patients who fall in these categories, as well as those with similar conditions mentioned earlier.
Of course, whether pre-surgical antibiotics is a wise choice for you will depend on your medical history and current health status. We'll consider all these factors thoroughly before advising you. But if you are more susceptible to infection, antibiotics before surgery could potentially lower your risk for an implant failure.
Twice a year dental cleanings are an important aspect of optimal oral health. But if you’re not brushing and flossing every day, your dental visits could change from regular maintenance to teeth rescue missions.
These two hygiene tasks don’t take long—a single trip with floss around each tooth and a couple of minutes of brushing at least twice a day—but you’ll need to perform them effectively to get the most out of them. Not to worry, though: with a little practice and helpful advice from us, this small investment in time and effort could save your teeth—and your money.
The first thing to know, though, is the reason behind brushing and flossing: to remove disease-causing bacterial plaque that can build up daily on teeth. Bacteria produce acid, which at elevated levels can erode enamel and lead to decay; and some bacterial strains can cause periodontal (gum) disease. These infections could ultimately lead to gum recession, bone deterioration and tooth loss.
Daily brushing and flossing lowers your risk of this occurring. It’s your preference in what order you do them, but for now let’s start with flossing.
There are a number of techniques—and tools—for effective flossing. If you’re using thread floss, simply cut off about 18 inches and wrap each end around the middle finger from each hand. Use the remaining fingers to create a small amount of floss between the two best fingers for a particular area of the mouth and gently pull the floss in between the tooth gap. Form a “C” shape around one of the tooth sides and rub up and down until you hear a squeak (which you’ll only hear if you use un-waxed floss). Now, repeat the action with the adjacent tooth, then move to the next and each succeeding gap and do the same until you’ve cleaned each side of each tooth.
When brushing, hold your toothbrush gently like a paintbrush or pencil at about a 45-degree angle with just a small amount of toothpaste on the end bristles. All it takes is a gentle scrubbing or wiggling motion and the abrasives and detergents in the toothpaste will do the rest. Just make sure you fully brush all your teeth and gum surfaces, which should take about two minutes.
Along with regular dental visits and a low-sugar diet to discourage bacterial growth, brushing and flossing will help you avoid disease and enjoy the best oral health possible.
If you would like more information on keeping your teeth and gums clean, 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 “Daily Oral Hygiene: Easy Habits for Maintaining Oral Health.”
For major-league slugger Giancarlo Stanton, 2014 was a record-breaking year. After the baseball season ended, he signed a 13-year, $325 million contract with the Miami Marlins — the biggest deal in sports history. But earlier that same year, Stanton suffered one of the worst accidents in baseball: He was hit in the face by an 88-mph fastball, sustaining multiple fractures, lacerations, and extensive dental damage.
After the accident, Stanton didn’t play for the remainder of the season. But now he’s back in Spring Training… and he’s got a not-so-secret weapon to help protect him against another injury: A custom-made face guard designed to absorb impacts and keep him from suffering further trauma.
As sports fans, we’re glad that Stanton was able to overcome his injury and get back in the game. As dentists, we’d like to remind you that you don’t have to be a major-league player to feel the harmful effects of a sports injury — and you don’t have to look far to find a way to protect yourself. In fact, you can get a custom-made mouthguard right here at the dental office.
Mouthguards have a long tradition in sports like football, boxing, and hockey. But did you know that far more Americans are injured every year playing “non-collision” sports like basketball, baseball — and even bicycling? And it doesn’t take a major-league fastball to cause a dental injury: The highest incidence of sports-related dental injuries occurs in 15-to-18-year-old males. In fact, about one-third of all dental injuries among children stem from various types of sports activities. These injuries may result in countless hours being lost from school and work, and cost significant sums for treatment and restoration.
Mouthguards have a proven track record in reducing dental and facial injuries: They are capable of absorbing the energy of a blow to the mouth, and dissipating it in a way that prevents damage to facial structures and teeth. But not all mouthguards are created equal: Custom-fabricated mouthguards, which are produced from an exact model of your mouth made right here in the dental office, offer by far the best protection. They fit better and safeguard the teeth more fully than any off-the-shelf or “boil-and-bite” type can. Plus, they’re more comfortable to wear. And let’s face it: No mouth guard can protect your teeth if you don’t wear it.
What’s more, some recent studies indicate that custom-made mouthguards may offer significant protection against concussion. An increasing awareness of the dangers that concussion may pose to athletes is one more reason why we recommend custom-made mouthguards to active people and their families.
To get his face guard, Giancarlo Stanton reportedly went to a specialist sporting-goods manufacturer in Illinois, and paid around $1,000. But you can get a custom-made mouthguard for yourself or your loved ones right at our office for a fraction of that price. And the peace of mind it can give you is… priceless.
If you have questions about custom-made mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “An Introduction to Sports Injuries & Dentistry” and “Athletic Mouthguards.”
Dental implants are considered the premier option for tooth replacement. While all implant procedures follow the same general concept — a titanium post surgically inserted into the jawbone with an attached life-like crown — the installation process can vary.
From their earliest history, implants have usually been installed through a two-stage process. In the first stage, the surgeon inserts the titanium post in the bone and leaves it “submerged” below the gum level to protect it from oral bacteria and the effects of chewing and biting. About three months later after the bone attaches to the titanium (a process called osseointegration), the surgeon then performs the second stage by re-exposing the implant and attaching a temporary abutment and crown for the patient to wear while the permanent abutment and crown are fabricated and later attached in 2-6 weeks.
In recent years, advancements in materials and design have made possible a one-stage process that allows the implant to protrude above the gum line during osseointegration and shortens the process. After the initial three-month healing period, the implant is ready for “loading” with the permanent crown.
The choice between which of these two procedures should be used for your implants will first depend on the type of tooth being replaced. A front tooth benefits from the one-stage procedure for cosmetic reasons because the surgeon can install a temporary crown to the exposed abutment during osseointegration (as long as the temporary tooth isn’t in functional contact with other teeth). An implant for a back tooth, on the other hand, doesn't have a large cosmetic demand so those one stage procedures usually end up with an exposed healing abutment but no temporary crown.
The strength of the bone is also a factor. Some bone tends to be softer, particularly in the back of the mouth. There’s a chance the implant could move in this softer bone, adversely affecting the outcome. For this reason, the two-stage procedure can be the preferred approach for posterior teeth as it offers more protection from movement.
You can be sure we’ll consider all these and other factors during your initial examination, and then advise you on the best approach. Above all, we want to make sure — whether a one-stage or a two-stage implant process — the result is a smile you can be proud of.
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 “Staging Surgery in Implant Dentistry.”
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