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NHLIronManKeithYandleSuffersDentalTraumaonIce

Professional Hockey player Keith Yandle is the current NHL “iron man”—that is, he has earned the distinction of playing in the most consecutive games. On November 23, Yandle was in the first period of his 820th consecutive game when a flying puck knocked out or broke nine of his front teeth. He returned third period to play the rest of the game, reinforcing hockey players’ reputation for toughness. Since talking was uncomfortable, he texted sportswriter George Richards the following day: “Skating around with exposed roots in your mouth is not the best.”

We agree with Yandle wholeheartedly. What we don’t agree with is waiting even one day to seek treatment after serious dental trauma. It was only on the following day that Yandle went to the dentist. And after not missing a game in over 10 years, Yandle wasn’t going to let a hiccup like losing, breaking or cracking nearly a third of his teeth interfere with his iron man streak. He was back on the ice later that day to play his 821st game.

As dentists, we don’t award points for toughing it out. If anything, we give points for saving teeth—and that means getting to the dentist as soon as possible after suffering dental trauma and following these tips:

  • If a tooth is knocked loose or pushed deeper into the socket, don’t force the tooth back into position.
  • If you crack a tooth, rinse your mouth but don’t wiggle the tooth or bite down on it.
  • If you chip or break a tooth, save the tooth fragment and store it in milk or saliva. You can keep it against the inside of your cheek (not recommend for small children who are at greater risk of swallowing the tooth).
  • If the entire tooth comes out, pick up the tooth without touching the root end. Gently rinse it off and store it in milk or saliva. You can try to push the tooth back into the socket yourself, but many people feel uneasy about doing this. The important thing is to not let the tooth dry out and to contact us immediately. Go to the hospital if you cannot get to the dental office.

Although keeping natural teeth for life is our goal, sometimes the unexpected happens. If a tooth cannot be saved after injury or if a damaged tooth must be extracted, there are excellent tooth replacement options available. With today’s advanced dental implant technology, it is possible to have replacement teeth that are indistinguishable from your natural teeth—in terms of both look and function.

And always wear a mouthguard when playing contact sports! A custom mouthguard absorbs some of the forces of impact to help protect you against severe dental injury.

If you would like more information about how to protect against or treat dental trauma or about replacing teeth with dental implants, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Dental Implants: A Tooth-Replacement Method That Rarely Fails” and “The Field-Side Guide to Dental Injuries.”

WhatYoucandotoEasethatBurningSensationinYourMouth

Have you ever felt a hot, burning sensation in your mouth—like it had been scalded—but you didn't eat or drink anything that could have caused it?

While you may think you’re hallucinating, there’s another possibility: Burning Mouth Syndrome (BMS). This condition, which can last for years, produces sensations in the mouth of not only scalding or burning, but also tingling, numbness and a decline in your ability to taste. Patients may feel it throughout their mouth or only in localized areas like the lips, tongue or inside the cheeks.

The exact cause of BMS is also something of a mystery. It’s been theoretically linked to diabetes, vitamin or mineral deficiencies and psychological problems. Because it’s most common among women of menopausal age hormonal changes have been proposed as a factor, although hormone replacement therapy often doesn’t produce any symptomatic relief for BMS.

To complicate matters, other conditions often share the condition’s effects, which need to be ruled out first to arrive at a BMS diagnosis. A feeling of scalding could be the result of mouth dryness, caused by medications or systemic conditions that inhibit saliva flow. Some denture wearers may display some of the symptoms of BMS due to an allergic reaction to denture materials; others may have a similar reaction to the foaming agent sodium lauryl sulfate found in some toothpaste that can irritate the skin inside the mouth.

If these other possibilities can be ruled out, then you may have BMS. While unfortunately there’s no cure for the condition, there are ways to lessen its impact. There’s even the possibility that it will resolve itself over time.

Until then, keep your mouth moist by drinking lots of water or using saliva-stimulating products, limiting alcohol, caffeinated drinks or spicy foods and refraining from smoking. If you’re taking medications that could cause dry mouth, speak with your physician about changing to an alternative. And try to reduce stress in your life through exercise, mindfulness practices or support groups.

While BMS isn’t considered harmful to your physical health it can make life less enjoyable. Careful symptom management may help improve your quality of life.

If you would like more information on Burning Mouth 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 “Burning Mouth Syndrome: A Painful Puzzle.”

By Occoquan Smiles
November 21, 2019
Category: Oral Health
Tags: fluoride  
FluoridatedDrinkingWaterHelpsCurbToothDecaySafely

The U.S. Centers for Disease Control and Prevention calls it “one of the ten most important public health measures of the 20th Century.” A new vaccine? A cure for a major disease? No—the CDC is referring to the addition of fluoride to drinking water to prevent tooth decay.

Fluoride is a chemical compound found in foods, soil and water. Its presence in the latter, in fact, was key to the discovery of its dental benefits in the early 20th Century. A dentist in Colorado Springs, Colorado, whose natural water sources were abundant with fluoride, noticed his patients' teeth had unusual staining but no tooth decay. Curious, he did some detective work and found fluoride in drinking water to be the common denominator.

By mid-century, fluoride was generally recognized as a cavity fighter. But it also had its critics (still lively today) that believed it might also cause serious health problems. Ongoing studies, however, found that fluoride in tiny amounts—as small as a grain of sand in a gallon of water—had an immense effect strengthening enamel with scant risk to health.

The only condition found caused by excess fluoride is a form of tooth staining called fluorosis (like those in Colorado Springs). Fluorosis doesn't harm the teeth and is at worst a cosmetic problem. And it can be avoided by regulating the amount of ingested fluoride to just enough for effectively preventing tooth decay.

As researchers have continued to learn more about fluoride, we've fine-tuned what that amount should be. The U.S. Public Health Service (PHS), which sets standards for fluoride in drinking water, now recommends to utilities that fluoridate water to do so at a ratio of 0.7 mg of fluoride to 1 liter of water. This miniscule amount is even lower than previous recommendations.

The bottom line: Fluoride can have an immense impact on your family's dental health—and it doesn't take much. Excessive amounts, though, can lead to dental staining, so it's prudent to monitor your intake. That means speaking with your dentist about the prevalence of fluoride in your area (including your drinking water) and whether you need to take measures to reduce (or expand) your use of it.

If you would like more information on how best fluoride benefits your family'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 “Fluoride & Fluoridation in Dentistry.”

GettingaNewToothinOneDayWillDependonYourBoneHealth

If you've thought the ads for a “new tooth in one day” seemed too good to be true, we have…sort of good news. You can get a new “tooth” in one visit, but only if your dental situation allows it.

The restoration in question is a dental implant, a metal post (usually titanium) surgically imbedded into the jawbone. They're especially durable because bone cells naturally grow and adhere to an implant's titanium surface, a process called osseointegration. Over time this process creates a strong bond between implant and bone.

Usually, we allow a few weeks for the implant to fully integrate with the bone before attaching the visible crown. With “tooth in one day,” though, we attach a crown at the same time as we install the implant, albeit a temporary crown. It's more aesthetic than functional, designed to avoid biting forces that could damage the implant while it integrates with the bone. When that process finishes, we'll install a permanent porcelain crown.

The health of your supporting bone and other structures will largely determine whether or not you're a candidate for this “tooth in one day” procedure. Your bone must be sufficiently healthy, as well as the gums surrounding the implant and the tooth's bony socket.

If, on the other hand, you have significant bone loss, gum recession or socket damage, we may first need to deal with these, usually by grafting tissue to the affected areas to stimulate new growth. Your implant, much less a temporary crown, will likely have to wait until the affected tissues have healed.

The bone can also be healthy enough for implant placement, but might still need time to integrate with the implant before attaching any crown. Instead, we would suture the gums over the implant to protect it, then expose and attach a permanent crown to the implant a few weeks later.

Obtaining even a temporary crown the same day as your implant can do wonders for your appearance. A more important goal, though, is a new tooth that you can enjoy for many, many years. To achieve that may mean waiting a little longer for your new beautiful smile.

If you would like more information on restoring missing teeth with dental implants, 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 “Implant Timelines for Replacing Missing Teeth.”

By Occoquan Smiles
November 01, 2019
Category: Dental Procedures
ViggoMortensensRed-CarpetSmile

The Golden Globes ceremony is a night when Hollywood stars shine their brightest. At the recent red-carpet event, leading man Viggo Mortensen had plenty to smile about: Green Book, the movie in which he co-starred, picked up the award for Best Motion Picture—Musical or Comedy. But fans looking at the veteran actor's big smile today might not realize that it once looked very different. A few years ago, an accident during the filming of The Two Towers took a major chip out of Mortensen's front tooth!

That might be OK for some movies (think The Hangover or Dumb and Dumber)—but it's not so great for everyday life. Fortunately, Mortensen visited a dentist promptly, and now his smile is picture-perfect. How was that accomplished? He didn't say…but generally, the best treatment for a chipped tooth depends on how much of the tooth's structure is missing.

If the tooth has only a small chip or crack, it's often possible to restore it via cosmetic bonding. This procedure can be done right in the dental office, frequently in a single visit. Here's how it works: First the tooth is cleaned and prepared, and then a tooth-colored resin is applied to the area being restored. After it is cured (hardened) with a special light, additional layers may be applied to build up the missing structure. When properly cared for, a tooth restored this way can look good for several years.

For a longer-lasting restoration, veneers may be recommended. These are wafer-thin shells made of durable material (most often porcelain) that cover the front (visible) surfaces of teeth. Strong and lifelike, veneers can match the exact color of your natural teeth—or give you the bright, high-wattage smile you've always wanted. No wonder they're so popular in Hollywood! Because veneers are custom-made for you, getting them may require several office visits.

If a chip or crack extends to the inner pulp of the tooth, a root canal procedure will be needed to keep the tooth from becoming infected—a situation that could have serious consequences. But you shouldn't fear a root canal! The procedure generally causes no more discomfort than filling a cavity (though it takes a little longer), and it can help save teeth that would otherwise be lost. After a root canal, a crown (cap) is generally needed to restore the visible part of the tooth.

When a damaged tooth can't be restored, it needs to be extracted (removed) and replaced. Today's best option for tooth replacement is a dental implant—a small, screw-shaped post inserted into the bone of your jaw that anchors a lifelike, fully functional crown. Implants require very little special care and can look great for many years, making them a top choice for tooth replacement

If you have questions about chipped or damaged teeth, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Artistic Repair Of Front Teeth With Composite Resin” and “Porcelain Veneers.”





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