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Posts for: May, 2018

26MillionFansLikeJustinBiebersChippedTooth

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.”


CoaxingImpactedTeethtotheRightPositioncanImproveYourSmile

What makes an attractive smile? Of course, shiny, straight and defect-free teeth are a big factor. But there’s another equally important element: all your teeth have come in.

Sometimes, though, they don’t: one or more teeth may remain up in the gums, a condition known as impaction.¬†And if they’re in the front like the upper canines (the pointed teeth on either side of the front four incisors) your smile’s natural balance and symmetry can suffer.

Impaction usually happens due to lack of space on a small jaw. Previously erupted teeth crowd into the space of teeth yet to come in, preventing them from doing so. As a result the latter remain hidden within the gums.

While impaction can interfere with the smile appearance, it can cause health problems too. Impacted teeth are at higher risk for abscesses (localized areas of infection) and can damage the roots of other teeth they may be pressing against. That’s why it’s desirable for both form and function to treat them.

We begin first with an orthodontic examination to fully assess the situation. At some point we’ll want to pinpoint the impacted teeth’s precise location and position. While x-rays are useful for locating impacted teeth, many specialists use cone beam CT (CBCT) technology that produces highly detailed three-dimensional images viewable from different vantage points.

If the tooth is in too extreme a position, it might be best to remove it and later replace it with a dental impact or similar restoration once we’ve completed other necessary orthodontic treatment. But if the tooth is in a reasonable position, we might be able to “move” the tooth into its proper place in the jaw in coordination with these other tooth-movement efforts to make room for it.

To begin this process, an oral surgeon or periodontist surgically exposes the tooth crown (the normally visible portion) through the gums. They then bond a small bracket to the crown and attach a small gold chain. An orthodontist will attach the other end to orthodontic hardware that will exert downward pressure on the tooth to gradually bring it into normal position.

Dealing with impacted teeth of this nature is often part of a comprehensive effort to correct the bite. If we’re successful, it could permanently transform both the smile and overall dental health.

If you would like more information on treating impacted teeth, 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 “Exposing Impacted Canines.”


By City Dental DC
May 10, 2018
Category: Oral Health
Tags: gum recession  
WatchOutforSignsofGumRecession

Your gums aren’t just for show—they also play an important role in supporting and protecting your teeth. Healthy gums are essential for healthy teeth.

Your gums can take a lot from daily chewing or other environmental factors. Unfortunately, disease or trauma can weaken their resilience. This weakening could lead to gum recession.

Gum recession occurs when the tissues covering a tooth begin to lose their attachment and shrink back (recede). As a result, the tooth appears “longer” as more of it that’s normally below the gum line becomes visible. Not only is gum recession unattractive, it also exposes more of the tooth to disease-causing bacteria.

The most common cause for gum recession is periodontal (gum) disease, an infection arising from the accumulation of a thin bacterial biofilm on the teeth called plaque. Infected gums become inflamed, a normal defensive response to isolate diseased or damaged tissues from the rest of the body. Chronic inflammation, however, weakens affected tissues over time and results in bone loss.

Other factors can also contribute to gum recession. A tooth that didn’t erupt properly and has come in away from the center of its protective bony housing can impede adequate gum coverage. Your gum tissue thickness, which you genetically inherit, can also increase the risk of gum recession. People with thinner gum tissues are more susceptible to recession than with thicker tissues.

You can also damage your gums (ironically) while trying to care for them. Over-aggressive brushing over time may traumatize the gums to the point that they recede. While it’s essential in removing disease-causing dental plaque, brushing only requires a gentle scrubbing action covering all portions of tooth surfaces. The brush bristles and mild abrasives in the toothpaste do most of the work of plaque removal.

To minimize the chances of gum recession, you should practice proper oral hygiene and visit your dentist regularly for professional cleanings and checkups. And you might also consider orthodontics for improperly positioned teeth that could not only improve your smile, but also your gum health.

And by all means see your dentist if you notice any signs of gum infection like swollen, reddened or bleeding gums. The sooner you begin gum disease treatment, the less likely your gums will recede in the future.

If you would like more information on recognizing and treating gum recession, 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 “Gum Recession: Getting Long in the Tooth.”