Although naturally resilient, your teeth still face some significant dangers. Tooth decay and gum disease, “enemies” within the mouth, can severely damage your teeth and eventually lead to their loss.
But there are also external dangers just as devastating — traumatic injuries that can happen in the blink of an eye. Fortunately, we can treat even the most serious of these injuries and increase the chances of an injured tooth’s survival.
Here are some of those common dental injuries:
Chipped or Fractured Teeth. This is a case where a part of the tooth has been broken but it’s still firmly rooted in the mouth. If small portions of the enamel or dentin (the next underlying layer of the tooth) have been chipped, we may be able to reattach them or fill the affected tooth area with a natural-colored filling (larger broken portions may require a complete crown). If the damage has injured or exposed the inner pulp, a root canal treatment might be in order to prevent infection and reduce pain.
Dislocated (Luxated) Teeth. A dislocation occurs when the impact moves the tooth in an abnormal way in the socket. We must first reposition the tooth and, if need be, stabilize it by splinting it to neighboring teeth. This type of injury may also require a root canal treatment.
Knocked out (Avulsed) Teeth. It’s quite possible to replant a knocked out tooth — if you act quickly. Without touching the root, the tooth should be rinsed with cold, clean water and then placed into the empty socket within five minutes of the injury. If placement isn’t possible, the tooth should be placed in a container with milk or with some of the injured person’s collected saliva (to keep the root from drying out), and sent with the injured person to treatment. We need to see the injured person as soon as possible to make sure the tooth is repositioned properly and take other measures to protect it. We’ll also need to monitor it for proper healing for awhile.
Although some injuries may be too severe to save a traumatized tooth, seeking immediate treatment certainly increases the chances for survival. If you or a family member experiences such an injury, keep calm and contact us immediately.
If you would like more information on treating dental injuries, 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 “Trauma & Nerve Damage to Teeth.”
When is the best time to floss your teeth: Morning? Bedtime? How about: whenever and wherever the moment feels right?
For Cam Newton, award-winning NFL quarterback for the Carolina Panthers, the answer is clearly the latter. During the third quarter of the 2016 season-opener between his team and the Denver Broncos, TV cameras focused on Newton as he sat on the bench. The 2015 MVP was clearly seen stretching a string of dental floss between his index fingers and taking care of some dental hygiene business… and thereby creating a minor storm on the internet.
Inappropriate? We don't think so. As dentists, we're always happy when someone comes along to remind people how important it is to floss. And when that person has a million-dollar smile like Cam Newton's — so much the better.
Of course, there has been a lot of discussion lately about flossing. News outlets have gleefully reported that there's a lack of hard evidence at present to show that flossing is effective. But we would like to point out that, as the saying goes, “Absence of evidence is not evidence of absence.” There are a number of reasons why health care organizations like the American Dental Association (ADA) still firmly recommend daily flossing. Here are a few:
- It's well established that when plaque is allowed to build up on teeth, tooth decay and gum disease are bound to follow.
- A tooth brush does a good job of cleaning most tooth surfaces, but it can't reach into spaces between teeth.
- Cleaning between teeth (interdental cleaning) has been shown to remove plaque and food debris from these hard-to-reach spaces.
- Dental floss isn't the only method for interdental cleaning… but it is recognized by dentists as the best way, and is an excellent method for doing this at home — or anywhere else!
Whether you use dental floss or another type of interdental cleaner is up to you. But the ADA stands by its recommendations for maintaining good oral health: Brush twice a day for two minutes with fluoride toothpaste; visit your dentist regularly for professional cleanings and checkups; and clean between teeth once a day with an interdental cleaner like floss. It doesn't matter if you do it in your own home, or on the sidelines of an NFL game… as long as you do it!
Every good oral hygiene regimen has two parts — the part you do (brushing and flossing) and the part we do (professional cleanings and checkups).
But what’s involved with “professional cleanings” — and why do we perform it? The “why” is pretty straightforward — we’re removing plaque and calculus. Plaque is a thin film of bacteria and food remnant that adheres to tooth surfaces and is the main culprit in dental disease. Calculus (tartar) is calcified plaque that occurs over time as the minerals in saliva are deposited in bacterial plaque. It isn’t possible for you to remove calculus regardless of your efforts or hygiene efficiency. Ample research has shown that calculus forms even in germ-free animals during research studies, so regular cleanings are a must to keep you healthy.
The “what” depends on your mouth’s state of health and your particular needs. The following are some techniques we may use to clean your teeth and help you achieve and maintain healthy teeth and gums.
Scaling. This is a general term for techniques to manually remove plaque and calculus from tooth surfaces. Scaling typically encompasses two approaches: instruments specially designed to remove plaque and calculus by hand; or ultrasonic equipment that uses vibration to loosen and remove plaque and calculus, followed by flushing with water and/or medicaments. Scaling can be used for coronal maintenance (the visible surfaces above the gum line) or periodontal (below the gum line).
Root planing. Similar to scaling, this is a more in-depth technique for patients with periodontal disease to remove plaque and calculus far below the gum line. It literally means to “plane” away built up layers of plaque and calculus from the root surfaces. This technique may employ hand instruments, or an ultrasonic application and flushing followed by hand instruments to remove any remaining plaque and calculus.
Polishing. This is an additional procedure performed on the teeth of patients who exhibit good oral health, and what you most associate with that “squeaky clean” feeling afterward. It’s often performed after scaling to help smooth the surface of the teeth, using a rubber polishing cup that holds a polishing paste and is applied with a motorized device. Polishing, though, isn’t merely a cosmetic technique, but also a preventative measure to remove plaque and staining from teeth — a part of an overall approach known as “prophylaxis,” originating from the Greek “to guard or prevent beforehand.”
If you would like more information on teeth cleaning and plaque removal, 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 “Teeth Polishing.”
In real life he was a hard-charging basketball player through high school and college. In TV and the movies, he has gone head-to-head with serial killers, assorted bad guys… even mysterious paranormal forces. So would you believe that David Duchovny, who played Agent Fox Mulder in The X-Files and starred in countless other large and small-screen productions, lost his front teeth… in an elevator accident?
“I was running for the elevator at my high school when the door shut on my arm,” he explained. “The next thing I knew, I was waking up in the hospital. I had fainted, fallen on my face, and knocked out my two front teeth.” Looking at Duchovny now, you’d never know his front teeth weren’t natural. But that’s not “movie magic” — it’s the art and science of modern dentistry.
How do dentists go about replacing lost teeth with natural-looking prosthetics? Today, there are two widely used tooth replacement procedures: dental implants and bridgework. When a natural tooth can’t be saved — due to advanced decay, periodontal disease, or an accident like Duchovny’s — these methods offer good looking, fully functional replacements. So what’s the difference between the two? Essentially, it’s a matter of how the replacement teeth are supported.
With state-of-the-art dental implants, support for the replacement tooth (or teeth) comes from small titanium inserts, which are implanted directly into the bone of the jaw. In time these become fused with the bone itself, providing a solid anchorage. What’s more, they actually help prevent the bone loss that naturally occurs after tooth loss. The crowns — lifelike replacements for the visible part of the tooth — are securely attached to the implants via special connectors called abutments.
In traditional bridgework, the existing natural teeth on either side of a gap are used to support the replacement crowns that “bridge” the gap. Here’s how it works: A one-piece unit is custom-fabricated, consisting of prosthetic crowns to replace missing teeth, plus caps to cover the adjacent (abutment) teeth on each side. Those abutment teeth must be shaped so the caps can fit over them; this is done by carefully removing some of the outer tooth material. Then the whole bridge unit is securely cemented in place.
While both systems have been used successfully for decades, bridgework is now being gradually supplanted by implants. That’s because dental implants don’t have any negative impact on nearby healthy teeth, while bridgework requires that abutment teeth be shaped for crowns, and puts additional stresses on them. Dental implants also generally last far longer than bridges — the rest of your life, if given proper care. However, they are initially more expensive (though they may prove more economical in the long run), and not everyone is a candidate for the minor surgery they require.
Which method is best for you? Don’t try using paranormal powers to find out: Come in and talk to us. If you would like more information about tooth replacement, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Crowns & Bridgework,” and “Dental Implants.”
While your chances of losing teeth increase as you age, it's not a given. With proper hygiene and care your teeth could last a lifetime.
But brushing and flossing can become more difficult in later years. Arthritis or strength issues in the fingers and hands make holding a toothbrush an arduous chore and flossing next to impossible.
But you can accommodate these physical changes. Many seniors find using a powered toothbrush much easier to handle and effective for removing disease-causing plaque. A tennis ball or bike handle grip attached to a manual toothbrush can also make it easier to handle. As to flossing, older people may find it easier to use floss threaders or a water irrigator, which removes plaque from between teeth with a pressurized water spray.
You may also find changes in the mouth that increase your risk for dental disease. One such issue is xerostomia, dry mouth. As you age you don't produce as much saliva, which neutralizes acid and restores minerals to enamel, as when you were younger. Dry mouth can also be a side effect of certain medications. Older people are also more likely to suffer from gastric reflux, which can introduce stomach acid into the mouth.
With these dry, acidic conditions, you're more susceptible to both tooth decay and periodontal (gum) disease. You can help offset it by increasing water consumption, taking a saliva stimulator, changing to alternative medications if available, and relieving gastric reflux.
Another area of concern in aging is the higher risk for inflammatory diseases like diabetes or cardiovascular diseases (CVD), which could also increase your risk of periodontal (gum) disease. Seeking treatment for gum disease and other similar systemic diseases may help ease the effects of each one.
Taking care of your mouth can be challenging as you grow older. But tooth loss and other unpleasant results aren't inevitable. Invest in your teeth and gums today and you're more likely to have a healthy life and smile all through your golden years.
If you would like more information on caring for your teeth and gums as you age, 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 “Aging & Dental Health.”
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