If you regularly participate in sports or other physical activity, you’re at a higher risk for dental injuries. While chipped teeth are the most common result of these injuries, a few may result in more serious trauma — dislodged, cracked or knocked out teeth. In these cases, the core of the tooth — the pulp — and the root may have been damaged. Saving the tooth may require endodontic treatment and possibly the expertise of a specialist in the field, an endodontist.
Endodontics, from the Greek words for “within” and “tooth,” is a specialty of dentistry that treats disease or damage affecting the inner parts of a tooth, particularly the pulp chamber, the root canals, and the root. While all dentists are trained in endodontic procedures, an endodontist has advanced training, experience and specialized equipment to address complex cases.
The type of endodontic treatment needed for an injured tooth will depend on the extent of damage. A mature, permanent tooth with pulp damage, for example, may require a root canal treatment. In this procedure the pulp chamber and root canals are thoroughly cleaned out, and then are filled with a special filling to prevent any future infection. Later the tooth should be crowned to permanently seal it. Although a general dentist may perform a root canal, more complex cases, such as a tooth with an extensive root canal network, may need to be performed by an endodontist using microscopic equipment.
A tooth that has undergone severe trauma, especially a knocked out tooth, will need extensive follow-up care by a general dentist and possibly an endodontist to improve its chances of long-term survival. Because of the severity, the tooth may lose viability and the body ultimately may begin to reject it. For this reason, the tooth should be monitored on a regular basis and may need further treatment from time to time, even up to five years after the injury.
One final word: if you participate in sports or exercise activity, you can significantly reduce your risk of dental injury with a mouthguard. There are various types, but the best protection is one custom designed to fit the specific contours of your mouth. We’ll be glad to advise you further on how to protect your teeth from injury.
If you would like more information on dental injury prevention and treatment, 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 “Trauma & Nerve Damage to Teeth.”
The CAT scan is a relatively recent technique in dentistry, used to get an image of what’s happening deep within your jaws. You may be wondering what a CAT scan tells us that a conventional x-ray picture does not, and whether it is worth the extra expense to get one. And how does a CAT scan compare with a conventional x-ray in terms of radiation exposure?
CAT stands for “computer assisted tomography.” Often it’s just called a CT scan, for “computerized tomography.” The word “tomography” comes from roots meaning “slice” and “write.” Tomographic techniques take repeated two dimensional pictures, similar to repeatedly slicing through an object, and then assembles them with a computer to produce a three dimensional (3-D) image.
The latest type of CT scan used in dentistry is called CBCT, or Cone Beam Computed Tomography. The Cone Beam refers to a spiral beam of x-rays, which is used to create a series of two dimensional images from which a computer creates a 3-D image. Such an image is of great value in assessing problems and planning treatment.
Here are just a few examples of how a CBCT scan can be used. Orthodontists can see skeletal structures and developing teeth that are still inside the jawbone while planning strategies for directing the teeth in order to arrive at a better bite. Oral surgeons can find impacted or missing teeth, see their locations, and view their proximity to nerves and sinuses, assisting them in planning surgeries. These scans are particularly useful for root canal specialists because they show root canals that are less than a millimeter wide and even reveal accessory canals that may not be visible on conventional x-rays. In cases of sleep disorders such as sleep apnea, a CBCT during sleep can be used to view a person’s airway and how it may be blocked by the tongue and other soft tissues in a person’s throat during sleep.
Compared to background radiation, the amount of radiation delivered in dental x-rays is minimal. A CBCT delivers a dose of radiation that is less than a typical full mouth x-ray series but more than a typical two dimensional panoramic radiograph. Generally CBCT scanners deliver lower doses than medical CT scanners.
With one low-dose CBCT scan, we can get an accurate idea of the internal structure of your bones and teeth and how they are situated in relation to each other. Prior to the availability of such images, many of these relationships had to be discovered in the course of a surgery or other treatment. Thus such a scan can aid greatly in the quality of treatment you will receive.
On the big screen, Australian-born actress Margot Robbie may be best known for playing devil-may-care anti-heroes—like Suicide Squad member Harley Quinn and notorious figure skater Tonya Harding. But recently, a discussion of her role in Peter Rabbit proved that in real life, she’s making healthier choices. When asked whether it was hard to voice a character with a speech impediment, she revealed that she wears retainers in her mouth at night, which gives her a noticeable lisp.
“I actually have two retainers,” she explained, “one for my bottom teeth which is for grinding my teeth, and one for my top teeth which is just so my teeth don't move.”
Clearly Robbie is serious about protecting her dazzling smile. And she has good reasons for wearing both of those retainers. So first, let’s talk about retainers for teeth grinding.
Also called bruxism, teeth grinding affects around 10 percent of adults at one time or another, and is often associated with stress. If you wake up with headaches, sore teeth or irritated gums, or your sleeping partner complains of grinding noises at night, you may be suffering from nighttime teeth grinding without even being aware of it.
A type of retainer called an occlusal guard is frequently recommended to alleviate the symptoms of bruxism. Typically made of plastic, this appliance fits comfortably over your teeth and prevents them from being damaged when they rub against each other. In combination with stress reduction techniques and other conservative treatments, it’s often the best way to manage teeth grinding.
Orthodontic retainers are also well-established treatment devices. While appliances like braces or aligners cause teeth to move into better positions, retainers are designed to keep teeth from moving—helping them to stay in those positions. After active orthodontic treatment, a period of retention is needed to allow the bite to stabilize. Otherwise, the teeth can drift right back to their old locations, undoing the time and effort of orthodontic treatment.
So Robbie has the right idea there too. However, for those who don’t relish the idea of wearing a plastic appliance, it’s often possible to bond a wire retainer to the back surfaces of the teeth, where it’s invisible. No matter which kind you choose, wearing a retainer can help keep your smile looking great for many years to come.
If you have questions about teeth grinding or orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Teeth Grinding” and “The Importance of Orthodontic Retainers.”
In the sports world, athletes are always looking for an edge. And it’s not just college or professional sports—even Little Leaguers are focused on enhancing their performance.
That’s why sports and energy drinks have rocketed in popularity. With marketing pitches promising to increase stamina or replace lost nutrients from strenuous workouts, it’s not unusual to find these beverages in sports bags or the team water cooler.
But there’s a downside to them regarding your dental health—they’re often high in sugar and acidity. Both drink types could increase your risk of tooth decay or periodontal (gum) disease over time.
Sugar is a primary food source for the bacteria that can trigger a gum infection. They also produce acid, which at high levels can erode tooth enamel and lead to tooth decay. The risk for enamel erosion also increases with the drink’s acidity.
You can lessen your risk of these unpleasant outcomes by restricting your consumption of these beverages. In fact, unless your sports activity is highly strenuous for long periods, your best hydration choice is usually water.
But if you do drink a sports or energy drink for an extra lift, be sure to take these precautions for the sake of your teeth:
Try to drink them only at mealtimes. Continually sipping on these drinks between meals never gives your saliva a chance to neutralize mouth acid. Reserving acidic foods and beverages for mealtimes will allow saliva to catch up until the next meal.
Rinse with water after your drink. Water usually has a neutral pH. This can help dilute mouth acid and reduce the mouth’s overall acidity.
Don’t brush right after drinking or eating. Increased acid that can occur right after drinking or eating can immediately soften tooth enamel, but saliva can neutralize and help restore minerals to tooth enamel within an hour. Brushing during this period could remove tiny bits of the enamel’s minerals.
Taking these precautions will help keep sports or energy drinks from eroding your tooth enamel. Once it’s gone, you won’t be able to get it back.
If you would like more information on protecting your tooth enamel, 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 “Think Before You Drink: Sports and Energy Beverages Bathe Teeth in Erosive Acids.”
For most people, raising kids is an expensive proposition. (A recent estimate by the U.S. Department of Agriculture puts the average tab at almost a quarter of a million dollars before they turn 18.) But if you’ve been keeping up with parenting news lately, you may have come across an even more jaw-dropping fact: According to a survey by the Sunstar group, a maker of oral hygiene products, when the tooth fairy makes a pickup in New York City, she (or her parental surrogate) leaves an average of $13.25 per tooth!
That compares to $9.69 per tooth in Los Angeles, $5.85 in Chicago and $5.02 in Boston — and it’s a far higher rate than most other polls have shown. But it brings up a good question: What's a baby tooth really worth? Ask a dentist, and you may get an answer that surprises you: A lot more than that!
A child’s primary (baby) teeth usually begin coming in around the age of 6 to 9 months, and start making their exits about the time a child reaches six years; by the age of 10 – 13, they’re usually all gone. But even though they will not last forever, baby teeth are far from disposable — and they deserve the same conscientious care as adult teeth. Here’s why:
Primary teeth play the same important roles in kids’ mouths as permanent teeth do in the mouths of adults: they allow kids to bite and chew effectively, speak normally and smile brightly. Their proper functioning allows children to get good nutrition and develop positive social interactions as they grow toward adolescence — and those are things it’s difficult to put a price tag on.
But that’s not all baby teeth are good for. Each one of those little pearly-whites serves as a guide for the permanent tooth that will succeed it: It holds a space open in the jaw and doesn’t let go until the grown-up tooth is ready to erupt (emerge) from beneath the gums. If primary teeth are lost too soon, due to disease, decay or accidents, bite problems (malocclusions) can develop.
A malocclusion (“mal” – bad; “occlusion” – bite) can result when permanent teeth don’t erupt in their proper locations. “Crowding” is a common type of malocclusion that can occur when baby teeth have been lost prematurely. The new, permanent teeth may come in too close together because neighboring teeth have shifted into the gap left by the prematurely lost tooth, creating an obstruction for the incoming teeth. In other cases, the permanent teeth may emerge in rotated or misplaced positions.
Bite problems make teeth harder to clean and thus more prone to disease; they may also cause embarrassment and social difficulties. The good news is that it’s generally possible to fix malocclusion: orthodontists do it every day. The bad news: It will almost certainly cost more than $13.25 per tooth. Alternatively, baby teeth in danger of being lost too soon can often be saved via root canal treatment or other procedures.
We’re not advocating giving big money to toddlers — but we do want to make a point: The tooth fairy’s payout: a few dollars. A lifetime of good checkups and bright smiles: incalculable.
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.