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.”
While gum recession is a common occurrence related to aging, it’s not just an “old person’s disease.” It can happen to anyone, even someone with a relatively healthy mouth. And this detachment and shrinking back of the gums from the teeth may not be a minor problem—your dental health is definitely at risk.
Here then are 4 things you should know about gum recession, and what you can do about it.
The most common cause: periodontal (gum) disease. A bacterial infection triggered by built-up dental plaque, gum disease weakens the gums’ attachment to teeth that leads to recession. To help prevent it, clean away plaque with daily brushing and flossing and visit a dentist regularly for more thorough plaque removal. If you already have gum disease, prompt treatment could stop the infection and reduce any resulting damage including recession.
…But not the only one. There are other factors that contribute to recession besides disease. In fact, it could be the result of “too much of a good thing”—brushing too hard and too frequently can damage the gums and lead to recession. You might also be more susceptible to recession if you’ve inherited thin gum tissues from your parents. Thin gums are at increased risk of recession from both disease and over-aggressive hygiene.
Best outcomes result from treating gum disease and/or recession early. The earlier we detect and treat a gum problem, the better the outcome. See your dentist as soon as possible if you see abnormalities like swollen or bleeding gums or teeth that appear larger than before. Depending on your condition there are a number of treatment options like plaque removal or techniques to protect exposed teeth and improve appearance.
Grafting surgery could regenerate lost gum tissue. While with mild cases of gum recession the gums may respond well to treatment and actually rejuvenate on their own, that might not be possible with advanced recession. We may, however, still be able to restore lost tissue through grafting. Using one of a number of techniques, a graft of donor tissue can foster new replacement growth. It’s a meticulous micro-surgical approach, but it could be a viable answer to extreme gum recession.
If you would like more information on gum recession, 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 “Gum Recession.”
Over a lifetime, teeth can endure temperatures ranging from freezing to near boiling, biting forces of as much as 150 pounds per square inch and a hostile environment teeming with bacteria. Yet they can still remain healthy for decades.
But while they’re rugged, they’re not indestructible — they can incur serious damage from tooth decay or periodontal (gum) disease, two of the most prevalent oral infections. If that happens, you could be faced with the choice of removing the tooth or trying to save it.
Because today’s restorations like dental implants are quite durable and amazingly life-like, it might seem the decision is a no-brainer — just rid your mouth of the troubled tooth and replace it. But from a long-term health perspective, it’s usually better for your gums, other teeth and mouth structures to try to save it.
How we do that depends on the disease and degree of damage. Tooth decay, for example, starts when high levels of acid soften the minerals in the outer enamel. This creates a hole, or cavity, that we typically treat first by filling with metal amalgam or, increasingly, composite resins color-matched to the tooth.
If decay has invaded the pulp (the innermost layer of the tooth), you’ll need a root canal treatment. This procedure removes infected material from the pulp and replaces the empty chamber and the root canals with a special filling to guard against another infection. We then cap the tooth with a life-like crown for added protection.
Gum disease, on the other hand, is caused by dental plaque (a thin film of bacteria and food particles on tooth surfaces), and requires a different approach. Here, the strategy is to remove all of the plaque and calculus (hardened plaque deposits) we can find with special hand instruments or ultrasonic equipment, and often over several sessions. If the infection extends deeper or has created deep pockets of disease between the teeth and gums, surgery or more advanced techniques may be necessary.
Though effective, some of these treatments can be costly and time-consuming; the tooth itself may be beyond repair. Your best move is to first undergo a complete dental examination. From there, we can give you your best options for dealing with a problem tooth.
If you would like more information on the best treatment approach for your 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 “Save a Tooth or Get an Implant?”
On your way to a more attractive smile, you’ll have to deal with some inconveniences while wearing braces like avoiding certain foods or habits or dealing with possible embarrassment about your new “metal smile.” But there’s one consequence of wearing braces that could dramatically affect your dental health: the difficulty they pose for keeping your teeth clean of dental plaque.
Dental plaque is a thin film of bacteria and food particles that if allowed to build up on tooth surfaces could trigger tooth decay or periodontal (gum) disease. Brushing and flossing thoroughly every day helps prevent this buildup.
Unfortunately, metal brackets and wires can get in the way and cause you to miss areas while performing these hygiene tasks. This could cause plaque buildup in those isolated areas that could trigger an infection. And if you (or someone you love) are also a teenager, the natural adolescent surge in hormones can increase your infection risk.
If while wearing braces you notice your gums are reddened, swollen or bleeding when you brush, these are all signs of infection and the body’s inflammatory response to it. The longer the infection continues, the weaker the tissues become, causing them to gradually detach from the teeth. Along with bone deterioration (another effect of the disease), this can ultimately lead to tooth loss.
To prevent this from happening, you’ll need to be as thorough as possible with daily brushing and flossing. To help make it easier, you can use special tools like an interproximal brush that can maneuver around the braces better than a regular brush. For flossing you can use a floss threader to more readily guide floss between teeth or a water flosser that uses a pressurized stream of water rather than floss thread to remove plaque.
This extra cleaning effort while wearing braces can greatly reduce your disease risk. But you’ll still need to keep an eye out for any symptoms like swollen or bleeding gums, and see your dentist as soon as possible. If the symptoms become severe you may need your braces removed until the disease can be brought under control. The health and future vitality of your teeth and gums is what’s of primary importance.
If you would like more information on dental care while wearing braces, 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 “Gum Swelling During Orthodontics.”
In her decades-long career, renowned actress Kathy Bates has won Golden Globes, Emmys, and many other honors. Bates began acting in her twenties, but didn't achieve national recognition until she won the best actress Oscar for Misery — when she was 42 years old! “I was told early on that because of my physique and my look, I'd probably blossom more in my middle age,” she recently told Dear Doctor magazine. “[That] has certainly been true.” So if there's one lesson we can take from her success, it might be that persistence pays off.
When it comes to her smile, Kathy also recognizes the value of persistence. Now 67, the veteran actress had orthodontic treatment in her 50's to straighten her teeth. Yet she is still conscientious about wearing her retainer. “I wear a retainer every night,” she said. “I got lazy about it once, and then it was very difficult to put the retainer back in. So I was aware that the teeth really do move.”
Indeed they do. In fact, the ability to move teeth is what makes orthodontic treatment work. By applying consistent and gentle forces, the teeth can be shifted into better positions in the smile. That's called the active stage of orthodontic treatment. Once that stage is over, another begins: the retention stage. The purpose of retention is to keep that straightened smile looking as good as it did when the braces came off. And that's where the retainer comes in.
There are several different kinds of retainers, but all have the same purpose: To hold the teeth in their new positions and keep them from shifting back to where they were. We sometimes say teeth have a “memory” — not literally, but in the sense that if left alone, teeth tend to migrate back to their former locations. And if you've worn orthodontic appliances, like braces or aligners, that means right back where you started before treatment.
By holding the teeth in place, retainers help stabilize them in their new positions. They allow new bone and ligaments to re-form and mature around them, and give the gums time to remodel themselves. This process can take months to years to be complete. But you may not need to wear a retainer all the time: Often, removable retainers are worn 24 hours a day at first; later they are worn only at night. We will let you know what's best in your individual situation.
So take a tip from Kathy Bates, star of the hit TV series American Horror Story, and wear your retainer as instructed. That's the best way to keep your straight new smile from changing back to the way it was — and to keep a bad dream from coming true.
If you would like more information about orthodontic retainers, please contact us or schedule an appointment for a consultation. You can learn more about this topic in the Dear Doctor magazine articles “Why Orthodontic Retainers?” and “The Importance of Orthodontic Retainers.” The interview with Kathy Bates appears in the latest issue of Dear Doctor.
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