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.”
For years people tuned in to enjoy one of David Letterman's "Top 10 lists," a frequent gag performed on his show Late Night. Each countdown list poked fun at off-the-wall topics like "Top 10 New York City Science Projects" or "Top 10 Questions People Ask when Shopping for an Umbrella."
Recently, the American Dental Association presented their own kind of list—"America's Top 3 Oral Health Problems"—based on surveys of around 15,000 people across the U.S. But unlike the popular Late Night lists, this one is no laughing matter.
Coming in at #3, 29% of the respondents indicated they had experienced tooth pain at some time in their life. Tooth pain is the body's way of alerting to trouble in the mouth, anything from a decayed tooth to a gum abscess. The best thing to do if you have any persistent oral pain is to see your dentist as soon as possible for a thorough examination. And you should do this even if the pain goes away.
The second most prominent oral problem among people is difficulty biting or chewing, about 31% of those in the surveys. As with tooth pain, the reasons can vary greatly, including cracked, loose or deeply decayed teeth, dentures or jaw joint disorders (TMD). Because dental disease is usually the ultimate culprit, the best way to avoid this is to practice daily brushing and flossing and regular dental visits. And, as with tooth pain, you should see your dentist if you're having symptoms.
At 33% of respondents, the number one oral problem in America is chronic dry mouth. It's a constant inadequate flow of saliva often caused by medications or certain systemic conditions. Because saliva helps protect the mouth against infection, a restricted flow increases your risk of disease. If you notice your mouth is dry all the time, you should talk to your dentist about ways to boost your saliva. If you're taking medications, ask your doctor if they could be causing your symptoms and if you could change to something else.
While any of these Top 3 oral problems can be a stepping stone to more serious dental problems, it doesn't necessarily have to lead to that. You can improve your dental health through daily oral hygiene and regular dental treatment. And it might help you stay off this unpleasant list.
If you would like more information on treating dental disease, 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 “Top 3 Oral Health Problems.”
Although cancer treatment has advanced steadily in recent decades, the most used therapies continue to be radiation and chemotherapy to eradicate cancerous cells. And while they often work, both can cause "collateral damage" in healthy tissues near the targeted cells.
This can create a number of indirect consequences for a patient's health, including in the mouth. The salivary glands, for example, can be damaged by radiation treatments aimed at the head or neck. The effect on these glands can interrupt the normal flow of saliva and cause xerostomia or "dry mouth."
Lack of adequate saliva causes more than an unpleasant, sticky mouth feeling. One of saliva's main functions is to neutralize acid that builds up naturally after eating. Without it, high acid levels can cause enamel and root surface erosion and lead to tooth decay.
Cancer treatment can also contribute to gastro-esophageal reflux disease (GERD). This disease causes stomach acid to bypass the natural tissue barriers of the esophagus and enter the mouth. As with dry mouth, the increased acid level from GERD can be just as devastating to enamel—and the damage will be permanent.
To minimize these effects on your dental health, it's important to take proactive steps before, during and after cancer treatment. If at all possible, have any needed dental work performed before you begin radiation or chemotherapy—it's better to start it with teeth and gums as healthy as possible.
During treatment, try to continue regular dental visits to monitor your oral health and receive any needed preventive or therapeutic treatments. Depending on your condition and the advice of your dentist, you may need to increase your visit frequency during this time. Your dentist can help with boosting your saliva production and strengthening your tooth enamel. But you should also practice daily brushing and flossing, drink plenty of water and seek treatment for any resulting GERD symptoms.
Even with the best efforts, though, your teeth and gums may still incur damage while treating your cancer. Fortunately, there are a wide array of materials and procedures that can effectively restore them to health. So, once your treatments are completed consult with a dentist on your options for improving the health and appearance of your teeth and gums.
While dental diseases tend to be a greater concern as we get older, they also pose a potential threat to children. A particular type of tooth decay called early childhood caries (ECC) can severely damage children's unprotected teeth and skew their normal dental development.
Fortunately, you can protect your child's teeth from disease with a few simple practices. First and foremost: start a hygiene habit as soon as possible to remove disease-causing bacterial plaque. You don't have to wait until teeth appear, either: simply wipe the baby's gums with a clean wet cloth after nursing to minimize the growth of oral bacteria.
When their teeth do begin to erupt, you can switch to brushing (you can add flossing as more teeth erupt—but until the child shows appropriate dexterity, you'll need to do it for them). For infants, brush gently but thoroughly with a soft-bristled brush and a smear of fluoride toothpaste. When they grow older you can increase the toothpaste to a pea-sized amount. And as soon as you can, get them involved with learning to perform these vital habits on their own.
You should also limit your child's consumption of sugar. Our favorite carbohydrate is also a favorite of bacteria, who consume any remnants in dental plaque as a primary food source. So, keep sugary snacks and foods to a minimum and limit them mainly to mealtimes. And don't put a baby to sleep with a bottle filled with a liquid containing sugar (including formula and breastmilk).
Finally, begin taking your child to the dentist regularly by their first birthday for routine cleanings and checkups. Besides removing any hard to reach plaque, your dentist may also apply sealants and topical fluoride to help protect and strengthen tooth enamel. Regular visits make it more likely to detect the early signs of decay, before it does extensive damage. And beginning early makes it less likely your child will develop a fear of dental visits that could carry on into adulthood.
These and other steps will go a long way in protecting your child's teeth and gums so they develop normally. A little prevention and protection will help ensure a happy, healthy smile later in life.
If you would like more information on helping your child develop healthy teeth and gums, 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 “Top 10 Oral Health Tips for Children.”
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
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