Posts for tag: dental injury
A traditional root canal procedure can be a “life-saver” for a decayed or injured tooth. But while it’s usually the best course for a damaged adult tooth, variations of the procedure are advisable for a new permanent tooth in a child or young adolescent.
This is because the inner pulp, the focus of the treatment, plays an important role in a young tooth’s development. When it first erupts a tooth’s dentin layer, the living tissue that makes up most of the body and roots of the tooth, hasn’t fully formed. The pulp increases the dentin layer over time in conjunction with jaw development.
Because a full root canal treatment removes all of the pulp tissue, it could interrupt any remaining dentin development in a young tooth. This could lead to poorly-formed roots and a less healthy tooth. For an immature permanent tooth, then, we would use variations of a root canal treatment depending on the nature and extent of the injury, the patient’s overall health and medications they may be taking.
Our main objective is to expose or remove as little of the pulp tissue as possible when treating the tooth. If the pulp hasn’t been exposed by the decay or injury, we may only need to remove the softened decayed or injured dentin while leaving harder dentin nearer the pulp intact. If, however, the pulp has become partially exposed by disease or injury, we would then perform a pulpotomy in which we remove only the exposed tissue and then place calcium hydroxide or mineral trioxide aggregate (MTA) to stimulate dentin growth that will eventually patch the exposure site.
In cases where decay or injury has rendered an immature tooth’s pulp tissue unsalvageable, we may use a procedure known as apexification that seals off the open, cylindrical root end of the tooth. This will allow bone-like tissue to grow around the root to serve as added support for the tooth. Although it can save a tooth in the short run, the tooth’s long-term survival chances may be lower.
By using these and other techniques we may be able to save your child’s immature tooth. At the very least, such a technique could postpone replacing the tooth until a more opportune time in adulthood.
If you would like more information on treating damaged teeth in 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 “Saving New Permanent Teeth after Injury.”
Although naturally resilient, your teeth still face some significant dangers. Tooth decay and gum disease, “enemies” within the mouth, can severely damage your teeth and eventually lead to their loss.
But there are also external dangers just as devastating — traumatic injuries that can happen in the blink of an eye. Fortunately, we can treat even the most serious of these injuries and increase the chances of an injured tooth’s survival.
Here are some of those common dental injuries:
Chipped or Fractured Teeth. This is a case where a part of the tooth has been broken but it’s still firmly rooted in the mouth. If small portions of the enamel or dentin (the next underlying layer of the tooth) have been chipped, we may be able to reattach them or fill the affected tooth area with a natural-colored filling (larger broken portions may require a complete crown). If the damage has injured or exposed the inner pulp, a root canal treatment might be in order to prevent infection and reduce pain.
Dislocated (Luxated) Teeth. A dislocation occurs when the impact moves the tooth in an abnormal way in the socket. We must first reposition the tooth and, if need be, stabilize it by splinting it to neighboring teeth. This type of injury may also require a root canal treatment.
Knocked out (Avulsed) Teeth. It’s quite possible to replant a knocked out tooth — if you act quickly. Without touching the root, the tooth should be rinsed with cold, clean water and then placed into the empty socket within five minutes of the injury. If placement isn’t possible, the tooth should be placed in a container with milk or with some of the injured person’s collected saliva (to keep the root from drying out), and sent with the injured person to treatment. We need to see the injured person as soon as possible to make sure the tooth is repositioned properly and take other measures to protect it. We’ll also need to monitor it for proper healing for awhile.
Although some injuries may be too severe to save a traumatized tooth, seeking immediate treatment certainly increases the chances for survival. If you or a family member experiences such an injury, keep calm and contact us immediately.
If you would like more information on treating dental 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 “Trauma & Nerve Damage to Teeth.”
Singer and actor Demi Lovato has a new claim to fame: formidable martial artist. When she is not in the recording studio, on stage or in front of the camera, Lovato can often be found keeping in shape at Jay Glazer's Hollywood (California) gym. Glazer, who is best known as a sports journalist, also runs conditioning programs for professional athletes and celebrities based on mixed martial arts. On March 6, Glazer got more than he bargained for when 5'3" Lovato stepped into the ring and knocked out his front tooth.
Glazer reportedly used super glue to put his tooth back together. Not a good idea! While it may not be convenient to drop everything and get to the dental office, it takes an expert to safely treat a damaged tooth. If you glue a broken tooth, you risk having to undergo major work to correct your temporary fix—it's no easy task to "unglue" a tooth, and the chemicals in the glue may damage living tooth tissue as well as the surrounding gum and bone.
Would you know what to do in a dental emergency? Here are some guidelines:
- If you chip a tooth, save the missing piece if possible. We may be able to reattach it.
- If your tooth is cracked, rinse your mouth with warm water, but don't wiggle the tooth around or bite down on it. If it's bleeding, hold clean gauze to the area and call our office.
- If your tooth is knocked loose or is pushed deeper into the socket, don't force the tooth back into position on your own. Immediate attention is very important.
- If your tooth is knocked out, there's a chance it can be reattached. Pick up the tooth while being careful not to touch the root. Then rinse it off and have either someone place into its socket, or place it against the inside of your cheek or in a glass of milk. Please call the office immediately or go to a hospital.
What's the best thing to do in an emergency? Call us right away, and DON'T super glue your tooth! You can prevent worse problems by letting a professional handle any dental issues. And if you've been living with a chipped, broken or missing tooth, call us to schedule an appointment for a consultation—there are several perfectly safe ways to restore your smile. Meanwhile, if you practice martial arts to keep in shape, think twice before getting into the ring with Demi Lovato!
Often as children grow older, their participation in sports or similar activities increases. While generally encouraged, this greater activity does increase injury risk, especially to the mouth.
In fact, the late childhood to early adulthood demographic is the most prone portion of the population to incur dental injuries. To complicate matters, their dental development is often incomplete, posing a number of treatment obstacles for an injured tooth.
For example, the primary means for preserving an injured adult tooth is a root canal treatment: damaged or diseased tissue within the pulp, the tooth’s innermost layer, is removed and the empty chamber and root canals filled and sealed to prevent infection. But while a fully matured tooth can function without the nerves and blood vessels of the pulp, a developing tooth needs these tissues for continued tooth formation. Otherwise, tooth development can stall and cause problems later on.
The most common solution for younger teeth is to remove any damaged tooth structure without disturbing the pulp if at all possible followed by a filling. That’s contingent, though, on whether we find the pulp unexposed or undamaged—if it is, we’ll try to remove only damaged or diseased pulp tissue and leave as much healthy tissue intact as possible. To aid with healing and tissue re-growth, we may also place medicinal stimulators between the pulp and the filling.
Jaw development may also pose a challenge if the injured tooth is too far gone and must be removed. Our best choice is to replace it with a dental implant; but if we install the implant while the jaw is still growing, it may eventually appear out of place with the rest of the teeth. It’s best to postpone an implant until full jaw maturity in early adulthood.
In the meantime we could provide a temporary solution like a removable partial denture or a modified bonded bridge that won’t permanently alter nearby teeth. These methods can adequately restore the function and appearance of missing teeth until the jaw is mature enough for an implant.
While injuries with young permanent teeth do pose extra challenges, we have effective ways to address them. With the right approach, the outcome can be just as successful as with a mature tooth.
If you would like more information on dental care in the formative years, 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 “Saving New Permanent Teeth after Injury.”
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.”