Posts for: April, 2014
It can happen in an instant — your child takes a hard hit to the mouth while playing football, basketball or some other contact sport. Suddenly, he or she faces the severest of dental injuries: a knocked out tooth.
There's both good and bad news about this situation. First, the good news: the knocked out tooth can be reinserted into its socket and take root again. The bad news, though, is that the tooth has only the slimmest of chances for long-term survival — and those chances diminish drastically if the reinsertion doesn't take place within the first five minutes of the injury.
Outside of the five-minute window, it's almost inevitable that the tooth root won't reattach properly with the tiny fibers of the periodontal ligament, the sling-like tissue that normally holds the tooth in place to the jawbone. Instead, the root may fuse directly with the bone rather than via the ligament, forming what is called ankylosis. This will ultimately cause the root to melt away, a process known as resorption, and result in loss of the tooth.
Of course, the resorption process will vary with each individual — for some, tooth loss may occur in just a few years, while for others the process could linger for decades. The best estimate would be four to seven years, but only if the tooth receives a root canal treatment to remove any dead tissue from the tooth pulp and seal it from possible infection. Over time the tooth may darken significantly and require whitening treatment. Because the tooth may be fused directly to the jawbone it can't grow normally as its neighbor teeth will and thus may appear uneven in the smile line. From a cosmetic point of view, it may be best at that time to remove the tooth and replace it with an implant or other cosmetic solution.
In many ways the longevity of the tooth post-injury really depends on time — the time it takes to reinsert the knocked out tooth into its socket. The quicker you take action, the better the chances the tooth will survive.
If you would like more information on treating a knocked out tooth, 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 “Knocked Out Tooth: How Long Will a Tooth Last After Replantation?”
When children begin losing their primary (“baby”) teeth, it’s a rite of passage — a sign that childhood is transitioning to future adulthood. And while it’s a normal part of dental development, it does bear watching for abnormalities.
Primary teeth are like deciduous tree leaves in that it’s their nature to shed and give way for new growth. They serve a purpose not only in providing children a means to bite and chew food, but also as guides for the permanent teeth that will soon erupt in their place.
As it reaches the end of its development within the jaw, the permanent tooth will begin to exert pressure on the primary tooth. This stimulates a process known as resorption where the primary’s roots begin to dissolve. This weakens its attachment to the jaw and the tooth becomes loose to the touch. At the end of this process, it doesn’t take much coaxing for the tooth to finally come out of its socket, with occasional minor bleeding and tenderness around the site. You will notice if you look at the bottom of the lost tooth that the roots have completely dissolved, leaving only a small indention.
This natural process, however, can run into complications. In their roles as permanent teeth guides, there’s a natural sequence for the loss of primary teeth; the permanent teeth develop along this sequence, which helps them erupt in the proper position. If a primary tooth is lost early and out of sequence (notably because of decay), the premature space can cause misalignment of the permanent teeth as they erupt.
That’s why it’s important for your child to have regular dental checkups, beginning sometime around their first birthday. This allows us to monitor primary tooth loss to make sure its progressing normally, as well as treat any condition such as tooth decay that could lead to premature loss. Regular checkups along with good oral hygiene practices will help ensure that the transition from primary to permanent teeth goes just as nature intended.
If you would like more information on the process of losing primary teeth in children, 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 “Losing a Baby Tooth.”
If you’ve come in to our office lately, chances are you’ve been asked to fill out a form or answer a question about what medications — both prescription and non-prescription — you are currently using. Of course, if you’re taking a blood-pressure drug or a pill to help control your cholesterol, you wouldn’t hesitate to put it on the list. But how about those vitamins and herbal supplements you take — do you really have to list those too?
The answer is a definite yes — and some of the reasons why may surprise you. Did you know that many “natural” dietary supplements can have potentially serious interactions with other drugs you may be prescribed? For example, herbal preparations made from the plant called St. John’s Wort are often used by people seeking relief from depression or anxiety. However, the active chemical compounds in this herb can interfere with some anesthetic drugs, and may make it harder for you to recover from the effects of anesthesia. Ginkgo biloba and some other commonly used herbs have a similar effect.
Even some vitamins have the potential to cause negative interactions. Large doses of Vitamin E, for example, can increase the risk of internal bleeding in people who are taking blood thinners or non-steroidal anti-inflammatory medications (NSAIDS), such as aspirin and ibuprofen. These medications are commonly prescribed for pain relief after minor dental procedures.
Does that mean you have to stop taking vitamins and herbal supplements if you may need a dental or medical procedure? Not necessarily. Vitamins are indeed vital to your health, and a deficiency in one or more of these important substances can result in serious diseases — like scurvy, which formerly plagued sailors lacking access to fresh fruits and vegetables. If you’ve been told you have a vitamin deficiency, taking vitamin pills is a must.
But the best way to get the proper amount of vitamins is through a healthy, well-balanced diet rich in fruits, vegetables, and whole grains. Not only does consuming these foods give you the most “natural” source of vitamins — it also provides you with other essential micronutrients and fiber, and it is low in fat and cholesterol.
No nutritional supplement is a substitute for a healthy diet — and that’s something we’d like everyone to remember. We’d also like to remind you to tell us about ALL the medications and supplements you’re taking, especially if you’re going to have a procedure. Giving us complete information will help ensure that you’ll remain as healthy and safe as possible.
If you have questions about dietary supplements, nutrition and your teeth, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine article “Vitamins & Dietary Supplements: What Every Consumer Should Know.”
It is sometimes hard to believe all of the features and characteristics that we inherit from our parents. Whether you're tall, short, blue-eyed or blonde, you can usually attribute some of these features to your mother and father. Of course, the downside of genetics is that diseases and disorders are also linked to genes.
Well, you can add gum tissue to that list as well! Genetics actually determines whether you have what we call “thin” or “thick” gum tissue. How does this work? Well, the type of gum tissue you have relies heavily on the shape of your tooth, which indeed is genetically-coded. If you have a triangular tooth shape, you'll likely have thin gums. If you have a squarer tooth shape, you'll usually have thick gums.
So, what can you expect from each tissue type?
If you have a thin gum tissue type, you are more likely to have gum recession. Watch out for the following signs of gum recession:
- Sensitivity to hot or cold, even without the presence of dental decay
- If you have crowns on your teeth, you may see a dark gray line at the gum line from the metal casting beneath the crown
- Small dark triangular spaces between teeth
On the other hand, if you have a thicker tissue type, your gums are more vulnerable to dental disease through a condition called “pocketing.” This happens when bacterial plaque causes your tissue to become inflamed, lose its attachment to the teeth and develop a pocket. Pocketing can result in bone loss, and, in worst-case scenarios, tooth loss.
It's important to note that while we use these terms to categorize different tissue types for treatment decisions, your tissue may also fall somewhere in between the two varieties.
So, how can you prevent gum disease? Daily oral hygiene is the best way to ensure proper care of your gums, no matter what type you have. Be sure to brush twice daily (use a soft toothbrush) and floss regularly at night. Floss gently until you hear a squeak, but watch out for your gum line. And of course, continue to visit us two times a year, so that we can assess whether you are in danger of developing gum disease.
If you would like more information about genetics and gum disease, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Genetics and Gum Tissue Types.”
When your baby’s first teeth erupt in the mouth, it’s a big step in their development. Unfortunately, you may not have much opportunity to celebrate — you’re too busy tending to your infant whose experience is anything but pleasant.
Commonly known as teething, the eruption process usually begins between six and nine months of age, although some children may begin as early as three months or as late as twelve. Not all teeth come in at the same time: it usually begins with the two lower front teeth, then the two upper front teeth, followed by the molars and then the canines (eye teeth). By age three, most children have all twenty of their primary teeth.
Each child’s teething experience is different and may vary in length of time and intensity. The usual signs are heightened irritability, biting and gnawing accompanied by gum swelling, ear rubbing, drooling and sometimes facial rashes. Babies also may have disturbed sleeping patterns and a decreased appetite. Occasionally, this discomfort can be intense.
There are some things you can do to ease this discomfort. Provide your baby a clean, chilled (not frozen) rubber teething ring, chilled pacifier or wet washcloth to gnaw on. Cold foods, like popsicles for older children can also be soothing, though you should limit sugary foods to lower the risk of tooth decay. You can also finger massage swollen gums to counteract the pressure coming from the erupting tooth, or administer pain relievers like baby acetaminophen or ibuprofen. You can use products with Benzocaine®, a numbing agent, for children two years or older — but you should never use alcohol for children of any age for inflamed gums.
Be sure to also set up a Year One dental examination around their first birthday. This is an important first step in your child’s long-term dental care, and a good opportunity to check their teething progress. And, by all means, if you have concerns about your child’s experience with teething, don’t hesitate to call our office.
Teething is a normal part of your child’s development. There’s much you can do to help make it as comfortable and pain-free as possible.
If you would like more information on teething, 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 “Teething Troubles.”