Posts for: February, 2020
Even though teeth are resilient, they're not indestructible. An accidental collision involving the face could damage teeth, even knocking a tooth completely out of its socket.
At first, it might seem like the end of the line for that particular tooth. But it doesn't have to be—if you know what to do. But you'll have to act quickly: The longer the tooth is out of its socket, the less chance it will survive long-term.
Here are the steps you should take to save a knocked-out tooth.
Find the tooth. It's important that you locate the missing tooth quickly. When you do, don't handle it by the root end: It still contains delicate periodontal cells that are essential if the tooth is going to rejoin with the ligaments and bone. Use clean water to rinse off any dirt or debris.
Reinsert the tooth. Holding it by the crown and not the root, reinsert the tooth into its empty socket, hopefully within an hour (the faster the better). You want to make sure it's good and snug, so apply a little force when you do this. Place some clean gauze or cloth between the tooth and its opposite on the other jaw, then have the person bite down and hold it in place.
Get immediate dental care. It's preferable to find a dentist as soon as possible (if not, then the nearest emergency medical facility). The dentist will x-ray the tooth to make sure it's positioned properly, and may adjust it further if necessary. They may also splint the tooth to adjacent teeth to help stabilize it until it fully reattaches with the jaw.
Again, time is of the essence—the quicker you can perform the above steps, the better the tooth's chances. Any delay could jeopardize the tooth's ability to reattach, or it could shorten its lifespan.
You can also get guidance on treating a knocked-out tooth and other dental emergencies with a free mobile app developed by the International Association of Dental Traumatology (IADT). Just look in your Android or IOS app store for ToothSOS.
If you would like more information on what to do during a dental emergency, 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 “When a Tooth is Knocked Out.”
Sometimes you need only a single solution to improve your smile: teeth whitening to brighten stained teeth; porcelain veneers or crowns to mask dental flaws; or a life-like dental implant to replace a missing tooth. But not all dental situations are that simple and sometimes require a combination of treatments.
A case in point: restoring a missing tooth within a poor bite. The absent tooth itself may be the cause of the bite problem if it’s been missing for some time: The nearby teeth tend to move or “drift” into the empty space, leaving no room for implant placement.
When this happens, you’ll first need orthodontic treatment to correct the bite problem. Not only will this open the space for the implant, it also comes with its own benefits. It obviously improves your smile appearance—but straighter teeth are also easier to keep clean of bacterial plaque, which reduces your disease risk. You may also experience better digestion after your teeth are properly aligned and able to function as they should during eating.
The traditional way to improve a bite is through metal braces. But there are some downsides: For one, braces can make it difficult to keep teeth adequately clean, making wearers more susceptible to tooth decay and gum disease. Braces are also quite visible and can detract from a person’s appearance (even more so if a missing tooth is involved).
Unless your situation requires braces, you can choose clear aligners as an alternative. These clear, computer-generated plastic trays are worn in sequence to gradually move teeth to their desired positions. Unlike braces, you can remove aligners for eating, cleaning or rare special occasions. And, they’re barely noticeable to others.
If you also have a missing tooth, you can have a temporary prosthetic (“false”) tooth built into your aligner trays. In this way you can still enhance your smile while undergoing aligner treatment.
Once your bite has been corrected, we can then proceed with restoring your missing tooth permanently with a dental implant. Although orthodontics adds to the time and expense of restoration, its often necessary to achieve the best result. Your future smile will be the better for it.
Just like adults, teenagers experience chipped, stained or disfigured teeth. And during a life stage where issues with appearance can be acutely painful, these defects call out for a solution.
And, there is one: porcelain veneers. These thin wafers of custom-made porcelain are bonded to the front of teeth to cover dental flaws. They’re one of the least invasive—and most affordable—methods for smile enhancement.
There is one caveat, though: The affected teeth will most likely need alteration. Veneers can look bulky when bonded directly to teeth, so we compensate for this by removing some of the surface enamel. This changes the tooth permanently, to the point that it will always require a veneer or some other form of restoration.
But although this may be a minor issue for an adult, it could pose a problem for a teenager. That’s because the pulp, the innermost layer of a tooth containing nerves and blood vessels, is larger in a younger adolescent tooth than in an older adult tooth. Because of its size, it’s closer to the tooth’s surface. During enamel reduction for veneers on a young tooth, this could lead to inadvertent nerve damage. If that happens, the tooth may need a root canal treatment to preserve it.
If the adolescent tooth needing a “facelift” has already been root canaled or sustained significant structural damage, then altering it for veneers may not be too concerning. Likewise, if the teeth are smaller than normal, the bulkiness of a veneer may actually improve appearance and not require alteration. We’ll need to examine a young patient first before making any recommendations.
There are also alternatives to veneers for improving smile appearance. Enamel staining could be enhanced temporarily with teeth whitening. Small chips can be repaired with bonded dental material, or in skilled hands be used to “build” a veneer one layer at a time with no enamel reduction. Although not as durable as regular veneers, these bonding techniques could buy time until the tooth is more mature for veneers.
Whichever path we take, there are effective ways to transform a teenager’s flawed tooth. And that can make for an even better smile.
If you would like more information on dental restorations for teenagers, 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 “Veneers for Teenagers.”