Posts for: July, 2018
In an instant, an accident could leave you or a loved one with a missing tooth. Thankfully, we can restore it with a dental implant that looks and functions like a real tooth—and the sooner the better.
But if the patient is a teenager or younger, sooner may have to be later. Because their jaws are still developing, an implant placed now could eventually look as if it's sinking into the gums as the jaw continues to grow and the implant doesn't move. It's best to wait until full jaw maturity around early adulthood and in the meantime use a temporary replacement.
But that wait could pose a problem with bone health. As living tissue, bone cells have a life cycle where they form, function and then dissolve (resorption) with new cells taking their place. This cycle continues at a healthy rate thanks to stimulation from forces generated by the teeth during chewing that travel through the roots to the bone.
When a tooth goes missing, however, so does this stimulation. Without it the bone's growth cycle can slow to an unhealthy rate, ultimately reducing bone volume. Because implants require a certain amount of bone for proper placement and support, this could make it difficult if not impossible to install one.
We can help prevent this by placing a bone graft immediately after the removal of a tooth within the tooth's "socket." The graft serves as a scaffold for new bone cells to form and grow upon. The graft will eventually resorb leaving the newly formed bone in its place.
We can also fine-tune and slow the graft's resorption rate. This may be preferable for a younger patient with years to go before their permanent restoration. In the meantime, you can still proceed with other dental treatments including orthodontics.
By carefully monitoring a young patient's bone health and other aspects of their dental care, we can keep on course for an eventual permanent restoration. With the advances in implantology, the final smile result will be worth the wait.
If you would like more information on dental care for trauma 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 “Dental Implants for Teenagers: Factors Influencing Treatment Planning in Adolescents.”
The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.
In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?
The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.
Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.
So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”
Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.
If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”
If you’re the kind of person who can’t do without a smart phone, you’ve probably heard the expression “There’s an app for that!” These nifty little programs let you get directions, check the weather, watch stock prices… even optimize your sleep patterns and make high-pitched dog whistles. And shortly, you’ll be able to check how well you’ve been brushing your teeth.
News reports have mentioned a soon-to-be-available toothbrush that will interface with an app on your smart phone. The brush has sensors that record how much time you spend brushing, whether you reach all parts of your mouth, and whether you brush correctly (with up and down motions, not just side to side). It charts your oral hygiene habits, scores your brushing technique — and, if you allow it, shares information about how well (or poorly) you’re doing with your family, friends… even your dentist.
So do you need to run out and buy one of these gizmos as soon as they’re available? Of course not! However, anything that encourages you to take better care of your oral hygiene can’t hurt. A wise dentist once said: The important thing is not the brush, but the hand that holds it.
If you’re a “gadget person,” you may be intrigued by the device’s high-tech design, and the fact that it interfaces with your phone. Plus, maybe the idea of compiling (and sharing) your brushing record has a certain appeal. On the other hand, you might prefer a sleek, light electric brush that doesn’t keep track of your movements. Or maybe the simplest brush of all — a manual one, with soft bristles and a comfortable handle — works best for you.
The most important thing is that you regularly practice good oral hygiene: Brush twice a day, for two minutes each time, and floss once a day. Use whichever brush is best for you, and be sure to change it every three months, or when the bristles get stiff. Stay away from sugary snacks between meals (they contribute to decay by keeping your teeth bathed in acidic byproducts). Don’t use tobacco in any form, or chew on things that don’t belong in your mouth. And remember to come in for regular exams and professional cleanings. If an app helps you do these things — we're all for it.
If you would like to learn more about maintaining good oral hygiene, please contact us or schedule an appointment for a consultation. For more information, see the Dear Doctor magazine article “Top 10 Oral Health Tips For Children.”