Posts for: August, 2018
A loose permanent tooth is not a good thing—and not something you should put off having examined. That’s because a loose tooth could soon become a lost tooth.
How we treat it depends on its underlying cause, which could be one of two types. One is primary occlusal trauma, meaning the affected tooth has experienced accidental trauma or higher biting forces than it normally encounters. This usually happens because of teeth grinding habits.
It could also be secondary occlusal trauma. Unlike primary trauma where the supporting gums and bone may be reasonably healthy, secondary trauma occurs because these structures have been severely damaged by periodontal (gum) disease. As the gums begin to detach from a tooth and its underlying bone deteriorates, even normal biting forces can loosen it.
If gum disease is present, our first priority is to bring it under control. We do this primarily by removing all dental plaque (a thin film of bacteria and food particles that triggers the infection and sustains it) and calculus or tartar (calcified plaque). This can take several sessions and, in the case of deep infection, may require a surgical procedure.
On the other hand, if teeth grinding is the primary cause, we’ll focus on minimizing the habit and its effects. One way is to create a custom-fitted guard worn to prevent upper and lower teeth from making solid contact. You may also need to improve your management of stress—another factor in teeth grinding—through medication, therapy or biofeedback.
In either case, improved periodontal health will help the gums naturally regain their strong attachment with help, if necessary, from gum tissue or bone grafting surgery. But this healing process can take time, so we may need to secure a loose tooth in the interim by splinting it to neighboring stable teeth. This usually requires bonding rigid material or metal across the back of all involved teeth or in a channel cut along the teeth’s biting surfaces. In this way the more stable teeth support the loose one.
Splinting may be temporary as the mouth heals from disease or trauma and the teeth regain their stability. In some cases, though, it may be permanent. Either way, dealing promptly with a loose tooth can help ensure it’ll survive—so see your dentist as soon as possible.
If you would like more information on treating loose 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 “Treatment for Loose Teeth.”
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.”
Unlike the months on either side, August isn't known for major holidays. But it does have one cause for celebration: National Fresh Breath Day! True, this observance will probably never achieve big-time recognition. Yet everyone would agree that fresh breath is something to appreciate! Unfortunately, bad breath is a persistent problem for many people. The first step in treating it is to identify the cause. Here are 5 common causes of bad breath:
1. Poor oral hygiene. Certain types of oral bacteria cause bad breath, and the mouth provides a perfect environment for them—especially when dental plaque and food debris is not well cleansed. So to keep your breath fresh, maintain a diligent oral hygiene routine. This includes brushing your teeth twice a day with fluoride toothpaste and flossing at least once a day. For an extra-clean mouth, use a tongue scraper—a plastic tool about the size of a toothbrush that's available in most drug stores. This will remove bacteria and food debris from your tongue for extra freshness.
2. Oral diseases. Bad odors in your mouth may also be caused by infections—which is what tooth decay and gum disease actually are. Sometimes old fillings wear out, allowing bacteria to re-infect a tooth that was once treated for decay. Other signs of these common oral diseases include tooth pain and bleeding or puffy gums. If you notice any of these, don't ignore it—make a dental appointment today!
3. Diet. Smelly foods will give you smelly breath; it's that simple. And the odors may linger after you have eaten them. When onion, garlic and other pungent foods are digested, their odor-producing substances enter your bloodstream and proceed to your lungs—which can affect how your breath smells. If you suspect your dietary habits are causing bad breath, try eliminating certain foods (at least temporarily) and see if that helps.
4. Dry mouth. Saliva helps cleanse your mouth, so reduced saliva flow can lead to bad breath. This accounts for "morning breath," which is caused when the mouth dries out during sleep (especially if you are a mouth-breather). However, some people don't produce enough saliva throughout the day. Sometimes it's just that they don't drink enough water. But a very common cause of chronic dry mouth is regular use of medications, both prescription and over-the-counter. If you notice that medication is drying out your mouth, let your doctor know. And stay hydrated!
5. Smoking. Given that smoking increases your risk for many serious diseases, including oral cancer, the fact that it can lead to bad breath seems almost trivial. Still, it's worth noting that smoking causes mouth odor both directly and indirectly by reducing the flow of saliva and promoting gum disease. In fact, tobacco in all forms is a hazard to your health.
If you'd like more information on bad breath, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Warning Signs of Periodontal (Gum) Disease” and “Dry Mouth.”