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.”
Twenty-six percent of American adults between 65 and 74 have lost all their teeth to dental disease. This isn’t an appearance problem only—lack of teeth can also harm nutrition and physical well-being.
Fortunately, we have advanced restorative options that can effectively replace missing teeth. Of these, there’s a tried and true one that’s both affordable and effective: removable dentures.
Dentures are simple in design: a plastic or resin base, colored with a pinkish-red hue to resemble gums to which we attach prosthetic (false) teeth. But while the design concept isn’t complicated, the process for creating and fitting them can be quite involved: they must conform to an individual patient’s jaws and facial structure if they’re going to appear natural.
If you’re considering dentures, here’s some of what it will take to achieve a successful outcome.
Positioning the teeth. The position of the prosthetic teeth on the base greatly determines how natural they’ll appear and how well they’ll function. So, we’ll need to plan tooth placement beforehand based on your facial and jaw structures, as well as photos taken of you before tooth loss. We’ll also consider how large the teeth should be, how far to place them forward or back from the lips, and whether to include “imperfections” from your old look that you see as part of your appearance.
Simulating the gums. While the teeth are your smile’s stars, the gums are the supporting cast. It’s important that we create a denture base that attractively frames the teeth by determining how much of the gums show when you smile, or adding color and even textures to better resemble gum tissue. We can also add ridges behind the upper teeth to support speech.
Balancing the bite. Upper and lower dentures don’t operate in and of themselves—they must work cooperatively and efficiently with each other during eating or speaking. So while appearance matters, the bite’s bite adjustment or balance might matter more. That’s why we place a lot of attention into balancing and adjusting the bite after you receive your dentures to make sure you’re comfortable.
This is a detailed process that we may need to revisit from time to time to make sure your dentures’ fit remains tight and comfortable. Even so, modern advances in this traditional restoration continue to make them a solid choice for total tooth loss.
If you would like more information on denture restorations, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor article “Removable Dentures.”
We often don't realize how important something is until it's gone. Like saliva: you're usually not aware that it's cleaning the mouth, neutralizing mouth acid or helping with digestion. But that could change if your saliva flow drops below normal: your health may soon suffer with your mouth taking the brunt.
In particular, reduced saliva flow increases your risk for tooth decay and periodontal (gum) disease. Both diseases are linked to oral bacteria. While many of the myriad strains in the mouth are beneficial, a few bacteria can infect and inflame gum tissues. Bacteria also produce acid, which can soften and erode enamel and make the teeth more susceptible to decay.
Saliva inhibits bacteria in a number of ways. It first clears the mouth of leftover food so not as much stays behind to form bacterial plaque, a thin film of food particles that builds up on teeth. You still need to brush and floss daily to remove plaque, but it's less effective without saliva's cleansing action. Saliva also contains antibodies that destroy disease-causing bacteria and other organisms, which keeps their populations in the mouth low.
One of saliva's most important functions, though, is buffering acid. The mouth's ideal pH level is neutral, but many foods we eat can cause it to become more acidic.Â Even a slight acidic rise after eating can soften the minerals in enamel. But saliva goes to work immediately and usually restores normal pH within a half hour to an hour. It also aids in re-mineralizing the enamel.
For these reasons, it's important for you to find out the cause of chronic dry mouth and treat it. If it's a side effect of your medication, talk to your doctor about an alternative, or drink more water before and after you take your dose. Certain products can also stimulate saliva flow, like chewing gum with xylitol, an alcohol-based sweetener that has dental health-protecting properties too.
Although you often don't notice this unsung bodily fluid swishing in your mouth, it's important that you take care of it. Keeping your saliva flowing will help ensure better oral health.
If you would like more information on the importance of saliva to 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 “Saliva: How it is used to Diagnose Disease.”
Since the discovery a century ago of its beneficial effect on tooth enamel, fluoride has become an important part of tooth decay prevention. It's routinely added to toothpaste and other hygiene products, and many water utilities add minute amounts of it to their drinking water supplies. Although there have been questions about its safety, multiple studies over the last few decades have eased those concerns.
Children especially benefit from fluoride during their teeth's developing years. Some children are at high risk for decay, especially an aggressive form known as Early Childhood Caries (ECC). ECC can destroy primary (baby) teeth and cause children to lose them prematurely. This can have an adverse effect on incoming permanent teeth, causing them to erupt in the wrong positions creating a bad bite (malocclusion).
For children at high risk for decay, dentists often recommend applying topical fluoride directly to the teeth as added protection against disease. These concentrations of fluoride are much higher than in toothpaste and remain on the teeth for much longer. Topical applications have been shown not only to reduce the risk of new cavities, but to also stop and reverse early decay.
Children usually receive these applications during an office visit after their regular dental cleaning. There are three different ways to apply it: gel, foam or varnish. To prevent swallowing some of the solution (which could induce vomiting, headache or stomach pain) the dentist will often insert a tray similar to a mouth guard to catch any excess solution. Varnishes and a few gels are actually painted on the teeth.
The American Dental Association has intensely studied the use of topical fluoride and found its application can result in substantial decreases in cavities and lost teeth. They've concluded this benefit far outweighs the side effects from ingesting the solution in children six years and older. With proper precautions and waiting to eat for thirty minutes after an application, the possibility of ingestion can be reduced even further.
While topical fluoride can be effective, it's only one part of a good dental care strategy for your child. Consistent daily brushing and flossing, a nutritious diet low in added sugar, and regular dental visits still remain the backbone of preventive care.
The long-running hit show Dancing with the Stars has had its share of memorable moments, including a wedding proposal, a wardrobe malfunction, and lots of sharp dance moves. But just recently, one DWTS contestant had the bad luck of taking an elbow to the mouth on two separate occasions—one of which resulted in some serious dental damage.
Nationally syndicated radio personality Bobby Bones received the accidental blows while practicing with his partner, professional dancer Sharna Burgess. “I got hit really hard,” he said. “There was blood and a tooth. [My partner] was doing what she was supposed to do, and my face was not doing what it was supposed to do.”
Accidents like this can happen at any time—especially when people take part in activities where there’s a risk of dental trauma. Fortunately, dentists have many ways to treat oral injuries and restore damaged teeth. How do we do it?
It all depends on how much of the tooth is missing, whether the damage extends to the soft tissue in the tooth’s pulp, and whether the tooth’s roots are intact. If the roots are broken or seriously damaged, the tooth may need to be extracted (removed). It can then generally be replaced with a dental bridge or a state-of-the-art dental implant.
If the roots are healthy but the pulp is exposed, the tooth may become infected—a painful and potentially serious condition. A root canal is needed. In this procedure, the infected pulp tissue is removed and the “canals” (hollow spaces deep inside the tooth) are disinfected and sealed up. The tooth is then restored: A crown (cap) is generally used to replace the visible part above the gum line. A timely root canal procedure can often save a tooth that would otherwise be lost.
For moderate cracks and chips, dental veneers may be an option. Veneers are wafer-thin shells made of translucent material that go over the front surfaces of teeth. Custom-made from a model of your smile, veneers are securely cemented on to give you a restoration that looks natural and lasts for a long time.
It’s often possible to fix minor chips with dental bonding—and this type of restoration can frequently be done in just one office visit. In this procedure, layers of tooth-colored resin are applied to fill in the parts of the tooth that are missing, and then hardened by a special light. While it may not be as long-lasting as some other restoration methods, bonding is a relatively simple and inexpensive technique that can produce good results.
If you would like more information about emergency dental treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor articles “The Field-Side Guide to Dental Injuries” and “Knocked Out Tooth.”
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