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.”
We've been using bridges to replace missing teeth for decades. Now, recently-developed implant-supported bridges are even more dependable, promising greater durability and less interference with remaining natural teeth.
But just like other restorations, you'll need to keep implant bridges clean to ensure their longevity. Although both the bridge and implants are impervious to disease, the supporting gums and bone aren't. If they become infected, they can break down and your restoration will fail.
Cleaning an implant-supported bridge includes flossing around each of the implants to remove dental plaque, a thin film of food particles and bacteria most responsible for dental disease. To perform this task, you'll have to pass the floss between the bridge and gums to access the sides of each implant.
To help make it easier, you can use a tool like a floss threader, a thin, shaft-like device with a loop on one end and a needle-like point on the other. You'll first thread about 18" of floss through the end and then pass the threader between the bridge and gums with the sharp end toward the tongue.
With the threader completely through, you'll then wrap the floss around your fingers as with regular flossing and move the floss up and down each side of the implants you can access. You'll then pull the floss out, reload the threader and move to the next section, repeating this process until you've flossed each side of each implant.
You can also use pre-cut floss with a stiffened end to thread between the bridge and gums or an interproximal brush with a thin bristled head that can reach underneath the bridge. And you might consider using an oral irrigator, a pump device that sprays a stream of pressurized water to remove and flush away plaque around implants.
To round out your hygiene efforts, be sure you visit your dentist at least twice a year for dental cleanings. Your dentist can also advise you and give you training on keeping your implants clear of disease-causing plaque. Cleaning around your implants will help ensure your restoration will last.
If you would like more information on caring for your dental restoration, 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 “Oral Hygiene for Fixed Bridgework.”
When your baby’s first teeth come in, you might not think it necessary yet to worry about tooth decay. But even infants can develop this common dental disease. In fact, it has a specific name in children 6 and under: early childhood caries (ECC).
About one-fourth of U.S. children have ECC, and poor or minority children are at highest risk. Because of primary (“baby”) teeth’s thin enamel layer, ECC can spread to healthier teeth with unnerving speed, causing extensive damage.
While such damage immediately affects a child’s nutrition, speech development and self-esteem, it could also impact their future oral health. Permanent teeth often erupt out of position because of missing primary teeth lost prematurely, creating a poor bite. And children with ECC are more likely to have cavities in their future permanent teeth.
While there are a number of effective treatments for repairing ECC-caused damage, it’s best to try to prevent it before damage occurs. A large part of prevention depends on you. You should, for example, begin oral hygiene even before teeth come in by wiping their gums with a clean, damp cloth after feeding. After teeth appear, switch to daily brushing with just a smear of toothpaste.
Because refined sugar is a primary food source for decay-causing bacteria, you should limit it in their diet. In the same vein, avoid sleep-time bottles with fluids like juices, milk or formula. As they grow older, make sure snacks are also low in sugar.
You should also avoid spreading your own oral bacteria to your baby. In this regard, don’t put their eating utensils or pacifier in your mouth and don’t drink from the same cup. Avoid kissing your baby on the lips. And above all, take care of your own oral health to prevent your own encounter with dental disease.
Finally, start regular dental visits on or before your baby’s first birthday. Regular cleanings and checkups increase the chances for early decay detection, as well as provide for treatments and prevention measures that can reduce the disease’s spread and destruction.
ECC can be devastating to both your baby’s current and future dental health. But with vigilance and good dental practices, you may be able to help them avoid this serious disease.
Besides daily hygiene and regular dental visits, the best thing you can do for your kids' dental health is to see that they're eating a nutritious diet. And not just at mealtime—healthy snacking also promotes healthy teeth and gums.
Healthy snack foods are quite similar to their counterparts at mealtime: fresh fruits and vegetables, whole grains and low-fat dairy. At the same time, you should avoid providing processed snacks high in sugar, salt, unhealthy fats and calories.
Managing snack choices at home is usually a simple matter of discipline and follow-through. When they're at school, however, it's a bit trickier as they may encounter snacks sold on school grounds or offered by fellow students that don't meet your definition of a healthy food. Public schools follow nutrition guidelines from the U.S. Department of Agriculture (USDA) on snacks sold on school grounds, but many dentists don't believe the standard goes far enough to protect dental health.
So, what can you do to combat these less healthy snack choices your kids may encounter at school? For one thing, you can work with your child's school officials to exceed the USDA guidelines or turn off snack vending machines right before lunch to lessen kids' temptation to skip lunch.
You can also interact with your children to better manage their schooltime snacking. But rather than issue blanket commands about what they should snack on at school, help them instead understand the difference between nutritional foods and less nutritional ones, and why it's important to choose healthy snacks for their life and health.
Finally, don't send them to school empty-handed—pack along nutritious snacks so that they won't seek out vending machines or their classmates to satisfy the munchies. You can supercharge your efforts with a little creativity (like a dash of cinnamon in a bag of unbuttered popcorn) that make your snacks fun and more enticing than other school ground options.
It's not always easy to keep your kids from unhealthy snack choices. But with a little commitment, interaction and ingenuity, you can help steer them toward snacks that are tooth-friendly.
If you would like more information on boosting your child's 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 “Snacking at School: How to Protect Your Child's Teeth and Promote Good Nutrition.”
Sometimes, looking at old pictures can really bring memories back to life. Just ask Stefani Germanotta—the pop diva better known as Lady Gaga. In one scene from the recent documentary Five Foot Two, as family members sort through headshots from her teen years, her father proclaims: "Here, this proves she had braces!"
"If I had kept that gap, then I would have even more problems with Madonna," Lady Gaga replies, referencing an ongoing feud between the two musical celebrities.
The photos of Gaga's teenage smile reveal that the singer of hits like "Born This Way" once had a noticeable gap (which dentists call a diastema) between her front teeth. This condition is common in children, but often becomes less conspicuous with age. It isn't necessarily a problem: Lots of well-known people have extra space in their smiles, including ex-football player and TV host Michael Strahan, actress Anna Paquin…and fellow pop superstar Madonna. It hasn't hurt any of their careers.
Yet others would prefer a smile without the gap. Fortunately, diastema in children is generally not difficult to fix. One of the easiest ways to do so is with traditional braces or clear aligners. These orthodontic appliances, usually worn for a period of months, can actually move the teeth into positions that look more pleasing in the smile and function better in the bite. For many people, orthodontic treatment is a part of their emergence from adolescence into adulthood.
Braces and aligners, along with other specialized orthodontic appliances, can also remedy many bite problems besides diastema. They can correct misaligned teeth and spacing irregularities, fix overbites and underbites, and take care of numerous other types of malocclusions (bite problems).
The American Association of Orthodontists recommends that kids get screened for orthodontic problems at age 7. Even if an issue is found, most won't get treatment at this age—but in some instances, it's possible that early intervention can save a great deal of time, money and effort later. For example, while the jaw is still developing, its growth can be guided with special appliances that can make future orthodontic treatment go quicker and easier.
Yet orthodontics isn't just for children—adults can wear braces too! As long as teeth and gums are healthy, there's no upper age limit on orthodontic treatment. Instead of traditional silver braces, many adults choose tooth-colored braces or clear aligners to complement their more professional appearance.
So if your child is at the age where screening is recommended—or if you're unhappy with your own smile—ask us whether orthodontics could help. But if you get into a rivalry with Madonna…you're on your own.
If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Orthodontics For The Older Adult.”
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