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.”
Chronic pain can turn your life upside down. While there are a number of disorders that fit in this category, two of them—fibromyalgia and temporomandibular disorders (TMD)—can disrupt your quality of life to the extreme. And it may be the two conditions have more in common than similar symptoms—according to one study, three-fourths of patients diagnosed with fibromyalgia show symptoms of TMD.
To understand why this is, let’s take a closer look at these two conditions.
Fibromyalgia presents as widespread pain, aching or stiffness in the muscles and joints. Patients may also have general fatigue, sleep problems, mood swings or memory failures. TMD is a group of conditions that often result in pain and impairment of the temporomandibular joints that join the jaw with the skull. TMD can make normal activities like chewing, speaking or even yawning painful and difficult to do.
Researchers are now focusing on what may, if anything, connect these two conditions. Fibromyalgia is now believed to be an impairment of the central nervous system within the brain rather than a problem with individual nerves. One theory holds that the body has imbalances in its neurotransmitters, which interfere with the brain’s pain processing.
Researchers have also found fibromyalgia patients with TMD have an increased sensitivity overall than those without the conditions. In the end, it may be influenced by genetics as more women than men are prone to have either of the conditions.
Treating these conditions is a matter of management. Although invasive techniques like jaw surgery for TMD are possible, the results (which are permanent) have been inconclusive in their effectiveness for relieving pain. We usually recommend patients try more conservative means first to lessen pain and difficulties, including soft foods, physical therapy, stretching exercises and muscle relaxant medication. Since stress is a major factor in both conditions, learning and practicing relaxation techniques may also be beneficial.
In similar ways, these techniques plus medication or cognitive-behavioral therapy that may influence neurotransmission can also help relieve symptoms of fibromyalgia. Be sure then that you consult with both your physician and dentist caring for both these diseases for the right approach for you to help relieve the effects of these two debilitating conditions.
If you would like more information on managing TMD or fibromyalgia, 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 “Fibromyalgia and Temporomandibular Disorders.”
Brushing and flossing are foundational to good oral health and an essential part of daily life. Practicing both these habits removes most disease-causing bacterial plaque from tooth and gum surfaces.
It doesn’t take much to manually perform them — a quality soft-bristle toothbrush, fluoride toothpaste and string floss. But what if you have a physical impairment that makes performing these tasks difficult to perform — or your mouth condition requires a little more “power” to adequately access and clean surfaces?
You do have power options for both brushing and flossing. Electric toothbrushes, of course, have been available since the 1950s. As with other technology, they’ve improved in quality and affordability over the last few decades. They’re available in various sizes, rechargeable or battery, and each with their own claims of cleaning ability.
The ultimate question, though, is: are they as effective at removing plaque as manual brushing? That’s been the subject of a number of comprehensive studies, including one conducted by the Cochrane Collaboration, a research organization. They evaluated a number of powered toothbrushes over various lengths of time. They concluded that some powered toothbrushes with a rotation-oscillation action had a statistically significant (though modest) reduction in plaque compared with manual toothbrushes.
As to flossing, admittedly it does take some dexterity to accomplish effectively. Traditional string flossing is also difficult if not impossible for people with braces or similar access restrictions to the teeth. An oral irrigator (or water flosser) is a viable alternative. Water flossers work by pulsating water at high pressure through special tips at the end of a handheld or countertop device. The pressurized stream penetrates between teeth and below the gums to flush away plaque.
Are water flossers effective? According to one recent study orthodontic patients were able to remove up to five times the plaque between teeth as those who used only a manual toothbrush.
When considering alternatives to your manual toothbrush or string floss, speak with us first. We’ll be happy to guide you toward the best form of brushing and flossing to do the most good in your situation.
Although oral cancer isn't the most prevalent among metabolic diseases, it is one of the most deadly with only a 50% survival rate after five years. That's because it can be difficult to detect in its early stages when treatment is most effective.
That's why prevention to reduce your chances of oral cancer is so important. Many people know quitting tobacco products, including smokeless varieties, and moderating alcohol consumption are key to any prevention strategy. But there's one other factor you should also consider: your diet.
We've learned quite a bit in the last few decades about how certain foods we eat contribute to the cancer disease process. Cancer seems to originate when elements in the body or environment (known as carcinogens) damage DNA, our unique genetic code, on the cellular level. For example, a class of chemicals called nitrosamines is a known carcinogen: we often encounter it in the form of nitrites used to preserve meat (like bacon or ham) or as byproducts in beer, seafood or cheese.
Another form of carcinogen is the unstable molecules produced during normal cellular function called free radicals. But our bodies have a natural neutralizer for free radicals called antioxidants. We obtain these substances in our food in the form of vitamins and minerals. While you can also ingest these in the form of supplements, the best way to obtain them is through a diet rich in plant-based food, particularly fruits and vegetables.
So in addition to lifestyle changes like quitting tobacco or moderating alcohol consumption, make sure your diet is a healthy and nutritious one. Limit your intake of processed foods (especially meats) and increase your portions of fresh fruits, vegetables and dairy products.
And don't neglect practicing effective brushing and flossing each day, along with regular dental cleanings and checkups. All of these healthy practices will greatly decrease your chances for life-threatening oral cancer.
If you would like more information on preventing oral cancer, 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 “Diet and Prevention of Oral Cancer.”
Boston Bruins defenseman Zdeno Chara had a rough Stanley Cup final against the St. Louis Blues this past June. Not only did the Bruins ultimately lose the championship, but Chara took a deflected puck shot to the face in Game Four that broke his jaw.
With the NHL season now over, the 42-year-old Bruins captain continues to mend from his injury that required extensive treatment. His experience highlights how jaw fractures and related dental damage are an unfortunate hazard in hockey—not only for pros like Chara, but also for an estimated half million U.S. amateurs, many in youth leagues.
Ice hockey isn't the only sport with this injury potential: Basketball, football (now gearing up with summer training) and even baseball players are also at risk. That's why appropriate protective gear like helmets and face shields are key to preventing injury.
For any contact sport, that protection should also include a mouthguard to absorb hard contact forces that could damage the mouth, teeth and gums. The best guards (and the most comfortable fit) are custom-made by a dentist based on impressions made of the individual's mouth.
But even with adequate protection, an injury can still happen. Here's what you should do if your child has an injury to their jaw, mouth or teeth.
Recognize signs of a broken jaw. A broken jaw can result in severe pain, swelling, difficulty speaking, numbness in the chin or lower lip or the teeth not seeming to fit together properly. You may also notice bleeding in the mouth, as well as bruising under the tongue or a cut in the ear canal resulting from jawbone movement during the fracture. Get immediate medical attention if you notice any of these signs.
Take quick action for a knocked-out tooth. A tooth knocked completely out of its socket is a severe dental injury. But you may be able to ultimately save the tooth by promptly taking the following steps: (1) find the tooth and pick it up without touching the root end, (2) rinse it off, (3) place it back in its socket with firm pressure, and (4) see a dentist as soon as possible.
Seek dental care. Besides the injuries already mentioned, you should also see a dentist for any moderate to severe trauma to the mouth, teeth and gums. Leading the list: any injury that results in tooth chipping, looseness or movement out of alignment.
Even a top athlete like Zdeno Chara isn't immune to injury. Take steps then to protect your amateur athlete from a dental or facial injury.
If you would like more information about dealing with sports-related dental injuries, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Athletic Mouthguards” and “The Field-Side Guide to Dental Injuries.”
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