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.”
Gum recession is an all too common problem for millions of people that if left untreated could lead to tooth and bone loss. But the good news is not only can the process be stopped, much of the damage can also be repaired through periodontal plastic surgery.
Gum recession occurs when the gum tissue protecting the teeth detaches and draws back to expose the root surface. This exposure may result in a range of effects, from minor tooth sensitivity to eventual tooth loss. There are a number of causes for gum recession, including overaggressive brushing or flossing, biting habits or badly fitting dentures or appliances.
The most prominent cause, though, is periodontal (gum) disease, a bacterial infection triggered by plaque buildup on tooth surfaces due to poor oral hygiene. Fortunately, early gum disease is highly treatable by thoroughly cleaning tooth, root and gum surfaces of plaque and calculus (hardened plaque deposits), along with possible antibiotic therapy, to reduce the infection and promote tissue healing.
Unfortunately, advanced cases of gum recession may have already resulted in extensive damage to the tissues themselves. While disease treatment can stimulate some re-growth, some cases may require reconstructive surgery to repair and further rebuild the tissues.
There are several techniques periodontists (specialists in gums, bone and other dental support structures) or dentists with advanced training can perform to “re-model” recessed gum tissues. One of the major areas is placing tissue grafts (either from the patient or a human donor) at the site to encourage further tissue growth. Properly affixing a graft requires a great deal of training, skill and experience, especially in cases where the graft may need to be connected with adjoining tissues to establish a viable blood supply for the graft.
In skilled hands, a periodontal surgical procedure is fairly predictable with minimal discomfort afterward. And the lasting effects are well-worth it — not only will your health benefit from restored gum tissue and greater protection for your teeth, you’ll also enjoy a more attractive smile.
If you would like more information the treatment of 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 “Periodontal Plastic Surgery.”
If you are dealing with tooth pain, gum disease, crowding, infection, or decay, your wisdom teeth could be to blame. These are all signs you need to have your wisdom teeth removed. If you do have any of these symptoms, it is important to see a dentist as soon as possible. The dentist can examine your wisdom teeth and determine if extraction is needed. At Frederick Dental Group, Dr. Dave Verma and Dr. Arpana Verma are your dentists for oral surgery in Frederick, MD.
Reasons for Removing Wisdom Teeth
One of the primary reasons wisdom teeth are removed is pain. Impacted or crowded wisdom teeth can cause extensive pain and discomfort. Extracting those teeth ultimately alleviates the pain and discomfort. Other reasons for removing wisdom teeth include:
- The wisdom teeth erupt only partially and are considered impacted.
- Crowding occurs following the eruption of the wisdom teeth due to insufficient space.
- The wisdom teeth become infected or develop areas of decay.
- Extensive pain and discomfort develop following full or partial eruption of the wisdom teeth.
Removal of Wisdom Teeth
Wisdom teeth can be removed by a dentist who performs oral surgery in Frederick. The procedure is performed in the dental office. Patients are usually given a sedative and/or local anesthetic to minimize pain during the procedure. The procedure can take a few hours, depending on whether some or all of the wisdom teeth are being removed.
Following extraction of the wisdom teeth, it is best to recover at home for a few days prior to resuming normal activities. Either over-the-counter or prescription pain medications can alleviate pain or discomfort, while applying an ice pack to the cheeks helps minimize bruising and swelling. Gauze pads can be used for any bleeding that occurs. In addition to pain medications, ice packs, and gauze pads, rinsing the mouth with salt water multiples per day is also helpful.
Signs you need to have your wisdom teeth removed include experiencing pain or discomfort following eruption, or developing crowding, infection, gum disease, or decay. To find out if your wisdom teeth require extraction, schedule an exam with either Drs. Dave and Arapana Verma by calling Frederick Dental Group, your center for oral surgery in Frederick, MD, at (301) 624-1001.
There are usually two moments when primary (“baby”) teeth generate excitement in your family: when you first notice them in your child’s mouth, and when they come out (and are headed for a rendezvous with the “tooth fairy”!).
Between these two moments, you might not give them much thought. But you should—although primary teeth don’t last long, they play a pivotal role in the replacing permanent teeth’s long-term health.
This is because a primary tooth is a kind of guide for the permanent one under development in the gums. It serves first as a “space saver,” preventing nearby teeth from drifting into where the permanent tooth would properly erupt; and, it provides a pathway for the permanent tooth to travel during eruption. If it’s lost prematurely (from injury or, more likely, disease) the permanent tooth may erupt out of position because the other teeth have crowded the space.
That’s why we try to make every reasonable effort to save a problem primary tooth. If decay, for example, has advanced deep within the tooth pulp, we may perform a modified root canal treatment to remove the diseased tissue and seal the remaining pulp from further infection. In some circumstances we may cap the tooth with a stainless steel crown (or possibly a white crown alternative) to protect the remaining structure of the tooth.
Of course, even the best efforts can fall short. If the tooth must be removed, we would then consider preserving the empty space with a space maintainer. This orthodontic device usually takes the form of a metal band that’s cemented to a tooth on one side of the empty space with a stiff wire loop soldered to it that crosses the space to rest against the tooth on the other side. The wire loop prevents other teeth from crowding in, effectively “maintaining” the space for the permanent tooth.
Regular dental visits, plus your child’s daily brushing and flossing, are also crucial in preventing primary teeth from an “early departure.” Keeping them for their full lifespan will help prevent problems that could impact your child’s dental health future.
If you would like more information on the right care approach for primary 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 “Importance of Baby Teeth.”
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.”
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