Posts for category: Oral Health
Your son has fallen and hit his face against a hard surface. Not only is he in pain but now there is also a chip missing from his front tooth. He is worried that his smile will never be the same. What should you do?
Answer: If you can find that missing chip, sometimes we can bond the fragment back on to the tooth. The tooth should be evaluated and repaired as soon as possible, although in the absence of other signs and symptoms of injury, and if your child is not in acute pain, it can probably wait up to 12 hours.
If the fragment can't be found, then the tooth can be restored with tooth-colored filling materials, which are also physically bonded to the natural tooth. Done well, these “composite resin” fillings can last for years and look perfectly natural. They may eventually need to be replaced with something more permanent.
If the chipped tooth is a child's primary (baby) tooth rather than a permanent (adult) tooth, the treatment will be similar.
However, a blow to a tooth can cause damage to the pulp — the living tissue within the tooth, which can become infected and die. If the damage to a primary tooth is too extensive it may be better to remove it to avoid damage to an underlying and developing permanent tooth. A place-holding appliance called a space maintainer may be used. If it is a permanent tooth it may need root canal treatment.
If a tooth is not chipped but is loosened or tender to the touch, it may require temporary stabilization, called splinting, until it has healed. Sometimes no treatment is required. If there has been a fracture to the tooth's root (the part below the gum line) it may heal by itself, or it may require further treatment especially if it is a permanent tooth, depending on the individual situation.
It is important to evaluate teeth that have been hit or damaged as a result of injury to ensure that they remain healthy and functional. We will keep track of the tooth or teeth, with observation, x-rays when necessary and monitoring over time to make sure no permanent damage has been done.
Contact us today to schedule an appointment or to discuss your questions about repairing a chipped tooth. You can also learn more by reading the Dear Doctor magazine article “The Field-Side Guide to Dental Injuries.”
Your toothbrush serves the invaluable purpose of minimizing bacterial buildup (plaque) that can irritate gums and lead to periodontal disease, infection of the bone and tissues supporting your teeth. Brushing also helps dislodge food particles that certain oral bacteria would otherwise feed on, producing acids in the process that can eat through protective tooth enamel and the vulnerable dentin below. Given its importance to your oral health, you can maximize your toothbrush’s effectiveness by using and storing it properly, and replacing it (or the brush head if you have a powered model) regularly.
Using and Storing Your Brush
All that’s needed to dislodge plaque from oral surfaces is a relaxed grip and a gentle jiggling motion. Too much pressure can wear away tooth enamel, cause gum tissue to recede, and shorten the life of your brush head.
When you’re done using your brush:
- Thoroughly rinse it to remove any remaining tooth paste, food particles, etc.
- If you’re super-vigilant, you also can disinfect your brush by soaking it in mouthwash, brush-sanitizing rinse, or a half water/half hydrogen peroxide solution, or dipping it in boiling water for 5 to 10 seconds.
- Air dry in an upright position and do not routinely cover your toothbrush or store it in a closed container. A dark, moist environment is more conducive to the growth of microorganisms.
Replacing and Recycling Your Toothbrush
Even with the best of care, toothbrush bristles become frayed and worn and their cleaning effectiveness diminishes after 3 or 4 months, according to the American Dental Association, though it could be sooner depending on factors unique to each patient. Besides checking the bristles regularly, a good way of keeping track is to write the date you start using your toothbrush in permanent pen on a big-enough spot on the handle (or doing it on masking tape applied to the base of a power brush).
Once your brush has passed its useful life for oral hygiene, you can still get plenty of mileage out of it. You’ll find plenty of ideas on the internet for cleaning grout between tiles and grime-filled spots around taps and toilet lid hinges; removing mud from boot treads; scrubbing off corrosion from around car battery terminals and more!
If you would like more information about oral hygiene, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Toothbrush Lifespan” and “Manual vs Powered Toothbrushes.”
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 you or a family member takes a traumatic hit to the mouth, what should you do? Besides immediate first aid, your next action will depend on the extent of damage to any teeth. What you do and when you do it may even determine whether an injured tooth is eventually saved or lost.
If a tooth has been completely knocked out, you have about five minutes to replace the tooth in the socket to give it the best chance of reattachment and long-term survival. While we can certainly perform this action in our office, getting to us within five minutes may not be possible. Fortunately, any person can perform this action on site (see the article linked below for basic instructions on replantation). If for some that's not possible, you should control bleeding at the tooth site with direct pressure, place the recovered tooth in milk or the patient's saliva, and see us as soon as possible.
If, however, the injured tooth has been obviously knocked out of line but not completely detached from its socket, you have a small cushion of time to seek dental treatment — but not much. For this degree of injury, you should see us within six hours of the incident. We will be able to determine the exact nature of the injury, and treat the condition by moving the teeth back into proper position and splinting them.
You have up to twelve hours for broken or chipped teeth still in their normal position. Try to locate and save any broken-off fragments — it may be possible to re-bond them to the teeth. Although it may not be as urgent as other situations, you should still seek treatment as soon as possible. A broken tooth could leave the inner pulp exposed — a situation that left untreated could lead to eventual tooth loss.
Traumatic injuries to the mouth can have serious consequences for your long-term dental health. With our consultation and treatment efforts, we can help you save an injured tooth.
If you would like more information on caring for 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 “The Field-Side Guide to Dental Injuries.”
Diabetes and periodontal (gum) disease are two types of inflammatory conditions that have more in common than was once thought. There is strong evidence to show that each of these diseases is a risk factor for the development and growth of the other. Studies have also found that treating one condition successfully may have a positive impact on the treatment of the other.
From the Greek meaning “to pass through the urine,” diabetes mellitus causes an abnormal rise in blood glucose level that can't be adequately controlled by insulin, the body's primary hormone for that task. Either the pancreas can't produce an adequate supply of insulin (as with Type 1 diabetes) or there is resistance to the hormone's effects (as with Type 2 and gestational/pregnancy diabetes). If you are a diabetic patient, you face many difficult issues with your health: your body develops an altered response to inflammation that may severely inhibit wound healing. You also may become more prone to chronic cardiovascular disease.
Periodontal (gum) disease describes a group of diseases caused by dental plaque, a whitish film that contains infection-causing bacteria. As infection rises within the gum tissues, the auto-immune system of the body responds to this threat and inflammation results. If the person is also a diabetic, this response may be impaired and may have a direct effect on how severe the periodontal disease progresses.
Periodontal disease can also affect your blood glucose level, if you are a diabetic. A number of studies have demonstrated that diabetic patients who have improved control of their periodontal disease through better oral hygiene and dental treatments have shown improvement in their blood sugar levels. There's even some evidence that effective periodontal treatment that reduces inflammation may improve the body's sensitivity to insulin. Likewise, bringing diabetes under control with supplemental insulin or positive lifestyle changes can help lessen the likelihood and severity of periodontal disease.
To sum it up, if you have been diagnosed with some form of diabetes, taking care of your teeth and gum tissues can have a positive impact on your diabetes. Likewise, making healthy changes in your lifestyle to bring your diabetes under control can reduce your risk for periodontal disease.
If you would like more information about periodontal disease and its effect along with diabetes, 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 “Diabetes and Periodontal Disease.”