Posts for: March, 2016
Teeth can take a lot of force over a lifetime of biting and chewing, thanks to enamel, their outer layer made of the strongest substance in the human body. Unfortunately, they’re not invincible: it’s even possible for you to break or “fracture” a tooth while biting or chewing normally.
Although such a fracture might seem to occur out of the blue, it’s usually related to a condition known as cracked tooth syndrome. It usually occurs in three stages: in the first, miniscule cracks in the outer enamel known as craze lines develop. They’re not immediately dangerous since they only involve the enamel surface; but left untreated they could deepen and progress to the next stage, a larger crack that penetrates the tooth’s underlying dentin.
If allowed to grow, this crack in turn can lead to the third stage, a full fracture that could extend down to the root. A fracture can put the tooth in danger of loss, especially if its inner pulp becomes exposed. To avoid this worst case, it’s best to treat the tooth at the earliest stage possible when craze lines are just developing.
There is a difficulty, though, with detecting craze lines — they’re small, too small to detect normally with x-rays. We, therefore, rely on other methods such as using an instrument called an explorer to feel for cracks, having the patient bite on a stick or rubber pad to replicate pain symptoms or using fiber-optic lighting with special dye stains to highlight possible cracks. Endodontists, specialists in root canals, can use microscopic equipment that’s quite adept at detecting craze lines.
There are also some signs you can be on alert for that might indicate a craze line or crack. If you feel a short, sharp pain — a “wince” — when chewing and releasing food, you could have a crack that hasn’t yet affected the nerves. If a true fracture occurs, the pain will intensify and you may notice pieces of the tooth coming off. If the crack extends to the root, the pain will become greater and more chronic.
It’s important then that you see us for any recurring pain symptoms as soon as possible. If it’s a crack, the sooner it’s treated the better your tooth’s chances for survival.
If you would like more information on cracked tooth syndrome, 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 “Cracked Tooth Syndrome.”
For anyone else, having a tooth accidentally knocked out while practicing a dance routine would be a very big deal. But not for Dancing With The Stars contestant Noah Galloway. Galloway, an Iraq War veteran and a double amputee, took a kick to the face from his partner during a recent practice session, which knocked out a front tooth. As his horrified partner looked on, Galloway picked the missing tooth up from the floor, rinsed out his mouth, and quickly assessed his injury. “No big deal,” he told a cameraman capturing the scene.
Of course, not everyone would have the training — or the presence of mind — to do what Galloway did in that situation. But if you’re facing a serious dental trauma, such as a knocked out tooth, minutes count. Would you know what to do under those circumstances? Here’s a basic guide.
If a permanent tooth is completely knocked out of its socket, you need to act quickly. Once the injured person is stable, recover the tooth and gently clean it with water — but avoid grasping it by its roots! Next, if possible, place the tooth back in its socket in the jaw, making sure it is facing the correct way. Hold it in place with a damp cloth or gauze, and rush to the dental office, or to the emergency room if it’s after hours or if there appear to be other injuries.
If it isn’t possible to put the tooth back, you can place it between the cheek and gum, or in a plastic bag with the patient’s saliva, or in the special tooth-preserving liquid found in some first-aid kits. Either way, the sooner medical attention is received, the better the chances that the tooth can be saved.
When a tooth is loosened or displaced but not knocked out, you should receive dental attention within six hours of the accident. In the meantime, you can rinse the mouth with water and take over-the-counter anti-inflammatory medication (such as ibuprofen) to ease pain. A cold pack temporarily applied to the outside of the face can also help relieve discomfort.
When teeth are broken or chipped, you have up to 12 hours to get dental treatment.Â Follow the guidelines above for pain relief, but don’t forget to come in to the office even if the pain isn’t severe. Of course, if you experience bleeding that can’t be controlled after five minutes, dizziness, loss of consciousness or intense pain, seek emergency medical help right away.
And as for Noah Galloway:Â In an interview a few days later, he showed off his new smile, with the temporary bridge his dentist provided… and he even continued to dance with the same partner!
If you would like more information about dental trauma, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Trauma & Nerve Damage to Teeth” and “The Field-Side Guide to Dental Injuries.”
Between infancy and the onset of puberty, your child will grow one set of teeth, lose it and grow another; their jaw structure will also change dramatically. This rapid development sets the course for their oral health later in life.
That’s why it’s so important to care for their teeth and gums in these early stages through daily hygiene and regular dental visits for disease prevention and treatment. Hygiene is the cornerstone of this care, and should begin in earnest when your child’s first tooth erupts in the gums, by first gently cleaning around the newly erupted teeth and gums after each feeding with a water-soaked gauze pad.
As they pass their first birthday you can switch to a small, soft-bristled toothbrush and just a smear of fluoridated toothpaste. Children should begin learning to brush around age 2, first by modeling you as you brush together. They should be adept enough by age 6 to brush on their own, at which time you can introduce flossing. We’re more than happy to advise you on technique for both of these hygiene tasks.
Age one is also the time for them to begin regular dental visits for cleanings and checkups. This will help us stay ahead of any developing decay or other issues and perform preventive treatments like dental sealants or fluoride applications. It will also help your child become comfortable with the dental office, which can make it easier for them to develop a long-term habit of regular dental care.
There are also habits you should practice (or avoid) that support good oral health for your child. For example, you shouldn’t allow them to sleep with a pacifier or a bottle filled with anything but water. Breast milk and formula contain some forms of sugar that bacteria can feed on; if this becomes too frequent it can result in higher acid levels that soften enamel and lead to decay. You should also take preventive actions to protect your child from teeth-damaging injuries like playing too close to hard furniture.
All these common sense measures support your child’s oral development. You can then let Nature takes its course as your child develops a healthy mouth for a lifetime.
If you would like more information on oral care for children, 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 “Top 10 Oral Health Tips for Children.”