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.”
Want to give your kids the best start possible for a lifetime of good dental health? The most important thing you can do is train them in effective brushing and flossing. It's more than having a nice smile and fresh breath: these hygiene tasks remove the daily buildup of bacterial plaque, the primary cause for both tooth decay and periodontal (gum) disease, which are most responsible for poor oral health.
But those aren't the only habits they should be cultivating. Here are 3 tips for helping your child develop great dental health habits.
Encourage healthy eating. Teeth and gums are like other parts of the body: they need the "building blocks" found in nutritious foods to help grow strong, healthy tissues. By focusing on a diet leaner on processed items and richer in whole, less-processed vegetables, meats and dairy products, you'll be helping your child build strong defenses against dental disease.
Keep sugary snacks under control. Of all the items in your child's diet, sugar could have the greatest impact on their teeth. Disease-causing bacteria thrive on this particular carbohydrate, multiplying and producing mouth acid—the main enemy of tooth enamel—as a byproduct. So, limit sugary snacks as much as possible, opting instead for more nutritional between-meal treats. In fact, try to make sure they only consume sugary treats at mealtime, not in between.
Encourage an end to thumb-sucking or pacifiers by age 3. Most infants and very young children suck their thumbs or, alternatively, a pacifier. There's no harm in this habit unless it extends into later childhood where it could affect their bite. You can avoid this outcome by encouraging your child with mainly positive reinforcement to stop sucking their thumbs or other objects before their third birthday. Your dentist can also help with tips and support in those efforts.
If you would like more information on dental care for your child, 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 “Help your Child Develop the Best Habits for Oral Health.”
Braces can be a long, involved process, but gaining a more attractive smile and better oral health is worth it. Sometimes, though, braces can produce unintended short-term consequences.
Brace brackets and wires do the work of moving teeth to better positions. They can, however, hinder the wearer's hygiene efforts to remove plaque, a thin film of bacteria and food particles, from tooth surfaces. Plaque buildup increases the risk of dental disease and other ill effects.
One such effect while you're wearing braces is the formation of tiny spots that look pale and chalky on otherwise smooth and polished enamel. These are white spot lesions (WSLs), where acid has remained for too long on the tooth enamel. They occur because acid-producing bacteria escape removal during brushing and flossing due to the braces hardware.
We want to try to prevent WSLs while wearing braces, and not just because they're unattractive. You're actually looking at enamel erosion, which could lead to cavity development at those weakened spots.
Although difficult for you as a braces wearer, daily brushing and flossing is crucial to WSL prevention. You'll need to take more time to be sure you're reaching all around the wires and brackets. You can improve your effectiveness with special brushes for braces and floss threaders or water irrigators. You can also help keep acid levels low by cutting back on acidic foods and beverages, especially sodas, coffee or spicy foods.
Even if you develop WSLs we can treat them effectively, especially if caught early. One way is by aiding enamel re-mineralization through saliva stimulation (the mouth's acid neutralizer) or applying fluoride to the teeth to strengthen enamel. We can also use caries infiltration, a technique that injects tooth-colored resin below the surface of the lesion. This strengthens the weakened enamel and gives the area the appearance of translucence like normal enamel.
While you're wearing braces, focus diligently on keeping your teeth clean of plaque and keep up your regular cleaning visits with us. If you notice any unusual discolorations or abnormalities, see us as soon as possible. Stopping WSLs from developing will help ensure your teeth are healthy and attractive after the braces come off.
If you would like more information on dental care with braces, 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 “White Spots on Teeth during Orthodontic Treatment.”
Dental implants are today’s preferred choice for replacing missing teeth. They’re the closest restoration to natural teeth—but at a price, especially for multiple teeth. If implants are beyond your current financial ability, there’s an older, more affordable option: a removable partial denture (RPD).
Similar in concept to a full denture, a RPD replaces one or more missing teeth on a jaw. It usually consists of a lightweight but sturdy metal frame supporting a resin or plastic base (colored pink to mimic gum tissue). Prosthetic (false) teeth are attached to the base at the locations of the missing teeth. Unlike transitional dentures, RPDs are designed to last for many years.
Although simple in concept, RPDs certainly aren’t a “one-size-fits-all” option. To achieve long-term success with an RPD we must first consider the number of missing teeth and where they’re located in the jaw. This will dictate the type of layout and construction needed to create a custom RPD.
In addition, we’ll need to consider the health and condition of your remaining teeth. This can be important to an RPD’s design, especially if we intend to use them to support the RPD during wear. Support is a fundamental concern because we want to prevent the RPD from excessively moving in place.
Besides dental support we’ll also need to take into account how the jaws function when they bite. The RPD’s design should evenly distribute the forces generated when you eat and chew so as not to create undue pressure on the bony ridges of the jaw upon which the RPD rests. Too much pressure could accelerate bone loss in the jaw, a common issue with dentures.
It takes a lot of planning to create a comfortably-fitting RPD with minimal impact on your dental health. But you’ll also have to maintain it to ensure lasting durability. You should clean your RPD daily, as well as brush and floss the rest of your teeth to minimize the chances of developing tooth decay or periodontal (gum) disease. You can further discourage disease-causing bacterial growth by removing them at night while you sleep.
A RPD can be a viable alternative to more expensive restorations. And with the right design and proper care it could serve you and your smile for a long time to come.
If you would like more information on removable partial dentures, 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 “Removable Partial Dentures.”
Fans of the primetime TV show The Middle were delighted to see that high school senior Sue, played by Eden Sher, finally got her braces off at the start of Season 6. But since this popular sitcom wouldn’t be complete without some slapstick comedy, this happy event is not without its trials and tribulations: The episode ends with Sue’s whole family diving into a dumpster in search of the teen’s lost retainer. Sue finds it in the garbage and immediately pops it in her mouth. But wait — it doesn’t fit, it’s not even hers!
If you think this scenario is far-fetched, guess again. OK, maybe the part about Sue not washing the retainer upon reclaiming it was just a gag (literally and figuratively), but lost retainers are all too common. Unfortunately, they’re also expensive to replace — so they need to be handled with care. What’s the best way to do that? Retainers should be brushed daily with a soft toothbrush and liquid soap (dish soap works well), and then placed immediately back in your mouth or into the case that came with the retainer. When you are eating a meal at a restaurant, do not wrap your retainer in a napkin and leave it on the table — this is a great way to lose it! Instead, take the case with you, and keep the retainer in it while you’re eating. When you get home, brush your teeth and then put the retainer back in your mouth.
If you do lose your retainer though, let us know right away. Retention is the last step of your orthodontic treatment, and it’s extremely important. You’ve worked hard to get a beautiful smile, and no one wants to see that effort wasted. Yet if you neglect to wear your retainer as instructed, your teeth are likely to shift out of position. Why does this happen?
As you’ve seen firsthand, teeth aren’t rigidly fixed in the jaw — they can be moved in response to light and continuous force. That’s what orthodontic appliances do: apply the right amount of force in a carefully controlled manner. But there are other forces at work on your teeth that can move them in less predictable ways. For example, normal biting and chewing can, over time, cause your teeth to shift position. To get teeth to stay where they’ve been moved orthodontically, new bone needs to form around them and anchor them where they are. That will happen over time, but only if they are held in place with a retainer. That’s why it is so important to wear yours as directed — and notify us immediately if it gets lost.
And if ever you do have to dig your retainer out of a dumpster… be sure to wash it before putting in in your mouth!
If you would like more information on retainers, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Why Orthodontic Retainers?”
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