By Jeffrey Mason, DMD
July 25, 2021
Category: Oral Health
Tags: dental injury  
TakeTheseImmediateActionstoSaveaKnocked-OutTooth

Accidents do happen, especially if you or a family member has an active lifestyle. One such risk, especially for someone playing a contact sport, is having a tooth knocked out.

But as extreme as this injury can be, it doesn't necessarily mean the tooth is lost forever. Gum (or periodontal) cells remaining on the tooth root can regenerate and regain their attachment with the periodontal ligament that holds teeth in place. But you have to act quickly—the longer the tooth is out of the socket, the more likely these cells will dry out and die.

So, by doing the following within 5-20 minutes of the injury (and the earlier the better), that knocked-out tooth has a reasonable chance of survival.

Locate and clean the tooth. Your first priority is to find the missing tooth and clean it of any debris with clean water. Be sure not to touch the root of the tooth and only handle the tooth by the crown (the visible part of a tooth when it's in the mouth).

Insert the root end into the empty socket. Still holding the tooth by the crown, insert the opposite root end into the empty socket. Orient the crown properly, but don't worry about getting it in just right—the follow-up with the dentist will take care of that. You will, however, need to apply some pressure to get it to seat firmly.

Secure the tooth. Place a piece of clean gauze or cloth between the reinserted tooth and its counterpart on the other jaw. Then, have the person bite down on the cloth and hold it. This will help secure the tooth in place while you travel to the dentist.

Seek dental care immediately. It's important to see a dentist immediately to adjust the tooth's position and to possibly splint the tooth to better secure it while it heals. If a dentist isn't available, then visit a local emergency room instead.

Taking these actions on the scene could mean the difference between saving and losing a tooth. But act quickly—the sooner you initiate first aid for a knocked-out tooth, the better its chances for long-term survival.

If you would like more information on what to do during dental emergencies, 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 “When a Tooth is Knocked Out.”

By Jeffrey Mason, DMD
July 15, 2021
Category: Oral Health
Tags: tooth pain  
DentalTreatmentDependsonWhatsReallyCausingYourToothPain

Not all toothaches are alike: Some are sharp and last only a second or two; others throb continuously. You might feel the pain in one tooth, or it could be more generalized.

Because there are as many causes as there are kinds of dental pain, you can expect a few questions on specifics when you come to us with a toothache. Understanding first what kind of pain you have will help us more accurately diagnose the cause and determine the type of treatment you need.

Here are a few examples of dental pain and what could be causing it.

Temperature sensitivity. People sometimes experience a sudden jolt of pain when they eat or drink something cold or hot. If it only lasts for a moment or two, this could mean you have a small area of tooth decay, a loose filling, or an exposed root surface due to gum recession. If the pain lingers, though, you may have internal decay or the nerve tissue within the tooth has died. If so, you may require a root canal treatment.

Sharp pain when chewing. Problems like decay, a loose filling or a cracked tooth could cause pain when you bite down. We may be able to solve the problem with a filling (or repair an older one), or you may need more extensive treatment like a root canal. In any event, if you notice this as a recurring problem, don't wait on seeing us—the condition could worsen.

Dull pain near the jaw and sinuses. Because both the jaws and sinuses share the same nerve network, it's often hard to tell where the pain or pressure originates—it could be either. You may first want to see us or an endodontist to rule out tooth decay or another dental problem. If your teeth are healthy, your next step may be a visit with a physician to examine your sinuses.

As you can see, tooth pain can be a sign of a number of problems, both big and small. That's why it's important to see us as soon as possible for an examination and diagnosis. The sooner we can treat whatever is causing the pain, the sooner your discomfort will end.

If you would like more information on treating dental pain, 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 “Tooth Pain? Don't Wait!

WhatChrissyTeigensInaugurationNightCapMishapCouldMeanForYou

Inauguration night is usually a lavish, Washington, D.C., affair with hundreds attending inaugural balls throughout the city. And when you're an A-List celebrity whose husband is a headliner at one of the events, it's sure to be a memorable night. As it was for super model Chrissy Teigen—but for a slightly different reason. During the festivities in January, Teigen lost a tooth.

Actually, it was a crown, but once she told a Twitter follower that she loved it “like he was a real tooth.” The incident happened while she was snacking on a Fruit Roll-Up (those sticky devils!), and for a while there, husband and performer John Legend had to yield center stage to the forlorn cap.

But here's something to consider: If not for the roll-up (and Teigen's tweets on the accident) all of us except Teigen, her dentist and her inner circle, would never have known she had a capped tooth. That's because today's porcelain crowns are altogether life-like. You don't have to sacrifice appearance to protect a tooth, especially one that's visible when you smile (in the “Smile Zone”).

It wasn't always like that. Although there have been tooth-colored materials for decades, they weren't as durable as the crown of choice for most of the 20th Century, one made of metal. But while gold or silver crowns held up well against the daily grind of biting forces, their metallic appearance was anything but tooth-like.

Later, dentists developed a hybrid of sorts—a metal crown fused within a tooth-colored porcelain shell. These PFM (porcelain-fused-to-metal) crowns offered both strength and a life-like appearance. They were so effective on both counts that PFMs were the most widely used crowns by dentists until the early 2000s.

But PFMs today make up only 40% of currently placed crowns, down from a high of 83% in 2005. What dethroned them? The all-ceramic porcelain crown—but composed of different materials from years past. Today's all-ceramic crowns are made of more durable materials like lithium disilicate or zirconium oxide (the strongest known porcelain) that make them nearly as strong as metal or PFM crowns.

What's more, coupled with advanced techniques to produce them, all-ceramic crowns are incredibly life-like. You may still need a traditional crown on a back tooth where biting forces are much higher and visibility isn't an issue. But for a tooth in the “Smile Zone”, an all-ceramic crown is more than suitable.

If you need a new crown (hopefully not by way of a sticky snack) or you want to upgrade your existing dental work, see us for a complete exam. A modern all-ceramic crown can protect your tooth and enhance your smile.

If you would like more information about crowns or other kinds of dental work, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Porcelain Crowns & Veneers.”

YouCanHaveaSuccessfulImplantOutcomeifYourDiabetesisUnderControl

Around one in ten U.S. adults have diabetes, a metabolic disease that can disrupt other aspects of a person's health like wound healing and vision. It could also cause complications with dental implants, the premier replacement choice for missing teeth.

There are two basic types of diabetes. In type 1 diabetes, the pancreas stops producing insulin, a hormone needed to regulate the amount of sugar glucose in the bloodstream. With the more prevalent type 2 diabetes, the body either doesn't produce enough insulin or doesn't respond efficiently to the insulin produced.

Uncontrolled diabetes can contribute to several dangerous health conditions. In addition to vision impairment and poor wound healing, diabetics are at higher risk for other problems like kidney disease or nerve damage. Drastic swings in blood glucose levels can also cause coma or death.

Many diabetics, though, are able to manage their condition through diet, exercise, medications and regular medical care. Even so, they may still encounter problems with wound healing, which could complicate getting a dental implant.

An implant is composed of a titanium metal post imbedded into the jawbone. Because of its affinity with titanium, bone cells naturally grow and adhere to the implant's metal surface. Several weeks after implant surgery, enough bone growth occurs to fully secure the implant within the jaw.

But this integration process may be slower for diabetics because of sluggish wound healing. It's possible for integration to not fully occur in diabetic patients after implant surgery, increasing the risk of eventually losing the implant.

Fortunately, though, evidence indicates this not to be as great a concern as once thought. A number of recent group studies comparing diabetic and non-diabetic implant patients found little difference in outcomes—both groups had similar success rates (more than 95 percent).

The only exception, though, were diabetic patients with poor glucose control, who had much slower bone integration that posed a threat to a successful implant outcome. If you're in this situation, it's better if you're first able to better control your blood glucose levels before you undergo surgery.

So, while diabetes is something to factor into your implant decision, your chances remain good for a successful outcome. Just be sure you're doing everything you can to effectively manage your diabetes.

If you would like more information on diabetes and dental 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 “Dental Implants & Diabetes.”

YouMayNotNeedPermanentToothAlterationWithTheseUltra-ThinVeneers

If you're looking for a cosmetic enhancement with a “light” touch, you can't beat dental veneers. These custom-made wafers of dental porcelain are bonded to the front of teeth to mask chips, heavy staining or gaps, revitalizing your smile.

But with traditional veneers, a minimal impact doesn't mean no impact at all. Although they're quite thin—often a millimeter or less—they can still look bulky when bonded to unprepared teeth. Dentists usually remove a small amount of surface enamel to help them appear more natural.

The alteration itself is painless, and only the bare minimum of enamel is removed. Even so, the alteration is permanent—the tooth will require a veneer or other form of restoration from then on. But a new kind of veneer may make it possible to avoid any enamel removal, or much less. These no-prep or minimal-prep veneers are even thinner, between 0.3 and 0.5 millimeters.

With these ultra-thin veneers, your dentist may only perform a little minor enamel re-shaping, particularly the sides of the teeth, to ensure a good fit. As thin as they are—akin to that of a contact lens—no-prep veneers can be bonded to the teeth surface without the need for fitting them under the gum line.

No-prep veneers are ideal for people with smaller than normal teeth, or that appear smaller due to other facial features. This also includes teeth that have worn down from age or teeth grinding, or those that are misshapen in some way. They also work well with people who have a narrow smile where less teeth than normal are visible in the “smile zone.”

They can also be used with patients who have oversized or prominent teeth, but it may still require some enamel removal. The only qualification for anyone receiving ultrathin veneers is that their enamel is in reasonably good health.

Because there's little to no alteration of the teeth, no-prep veneers can be reversed. Removing them, though, is no easy task, so you'll still need to think long-term before obtaining one. All in all, though, no-prep veneers in the right setting can still transform your smile without much permanent change to your teeth.

If you would like more information on no-prep veneers, 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 “No-Prep Porcelain Veneers.”





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