Posts for: July, 2017
Once they learn to walk, there's no stopping most children. Sometimes it can be a little jarring, as when you discover your toddler on top of the kitchen counter reaching in the cupboard on tip-toes for a snack!
Fortunately, children are fairly resilient. Unfortunately, they're not invincible — some of their adventures could result in physical injuries, especially to the highly vulnerable area of the mouth.
Even if you've carefully “child-proofed” your home, it's still best to be prepared for mishaps. Here are 3 common dental injuries and how to handle them.
Soft tissue injuries. Making contact with the ground or hard objects like furniture can injure the lips, tongue, cheeks or gums and cause bleeding, cuts or bruising. First, clean the area with clean water and a cloth or gauze as best you can, making sure there aren't any trapped pieces of tooth or dirt. Apply gentle, continuous pressure with a clean cloth to control bleeding, and apply ice packs or cold compresses for swelling. Don't apply bleach, aspirin or similar medications to open wounds. If the bleeding won't stop or the wounds look serious or deep, go to an emergency room.
Chipped or displaced tooth. A blunt force mouth injury can chip or push (displace) teeth out of position. In this case try to save any chipped pieces you find — your dentist may be able to re-bond them to the tooth. A displaced tooth is a dental emergency, so contact your dentist immediately. Don't try to re-position the tooth yourself unless it's completely knocked out.
Knocked-out tooth. Actions to take with a knocked-out tooth depend on whether it's a permanent or primary (baby) tooth. If permanent, rinse the tooth with clean water. Handle it by the crown (never by the root) and gently place it back in the empty socket. If that's not possible, place the tooth between your child's cheek and gum (if the child is old enough not to swallow it by mistake. You can also place it in a glass of cold milk. Get to a dentist or an emergency room as soon as possible — minutes count for a successful reattachment. Conversely, don't try to put a primary tooth back in its socket — you could damage the developing permanent tooth beneath the gum line. But do see a dentist as soon as possible for an examination.
Allergic reactions aren't necessarily bad: they're your body's responses to possible threats from foreign substances. But the response can go too far and cause a reaction as minor as a skin rash or as life-threatening as a multi-system shutdown called anaphylaxis.
Anything can cause an allergy: animal fur, food, chemicals — or metals. Because metals play such a large role in dental care, it's only natural we're alert to the possibility of allergic reactions from a procedure.
But don't postpone your implants or other dental work just yet — the threat isn't nearly that ominous. Here are a few facts about dental metal allergies to help you sort it out.
Allergic reactions are rare for metals used in medical and dental procedures. Although reactions to metals in joint replacements or coronary stents leading to failure do happen, actual occurrences are rare. Most metal allergies manifest as a skin reaction to jewelry or clothing. It's less likely with medical or dental metals because they're chosen specifically for their compatibility with living tissue.
Amalgam fillings account for most dental work reactions. Dentists have used this multi-metal alloy for fillings and other restorations for well over a century. Tooth-colored resins are now used for most fillings, but amalgam is still used in less visible back teeth. It's very rare for a person to experience a reaction to amalgam, but when it does occur it usually results in minor inflammation or a rash.
Implant titanium isn't just bio-compatible — it's also osteophilic. Titanium is the perfect choice for implants not only because it's tissue friendly, but also because it's bone friendly (osteophilic). Once implanted in the jaw, bone cells naturally grow and adhere to it to create a more durable bond. Not only does the body usually tolerate titanium, it welcomes it with open arms!
While it's still possible for you to have an allergy to implant titanium, the chances are remote. In one recent study involving 1,500 implant patients, titanium allergies occurred in less than 1%. So the chances are high a metal allergy won't stop you from obtaining a smile-transforming restoration with dental implants.
If you would like more information on allergies and dental work, 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 “Metal Allergies to Dental Implants.”
You've seen ads for “Teeth in One Day” that promise immediate implant placement at the same time you have the problem tooth removed. But this presumes the gums and underlying bone are healthy and able to support and protect the implant. If that's not the case, it may be ill-advised to place an implant on the same day.
Even with immediate placement, there will be a small degree of bone and gum opening or space around the implant after it's placed into the socket. This can often be remedied by placing a bone graft and sometimes a gum graft when we install the implant. It's also possible for natural healing to gradually fill in the space, but we'll need to monitor the site carefully for several weeks.
On the other hand, if we detect significant bone loss (or strongly suspect it will occur), immediate placement may not be an option — there's not enough bone or it's too weak to support an implant. In this case, it's necessary to wait on placement and focus on improving the bone health and quantity, beginning when we remove the old tooth and place a bone graft.
After completing the extraction, we typically place a bone graft in the empty socket. The graft will become a “scaffold” for new bone cells to grow upon. We may then allow about two to four months for new bone to partially replenish the area and then place the implant. The bone will continue to regenerate as it grows and attaches to the titanium implant to create a solid attachment.
If the site, however, still appears fragile even after partial bone growth, we may opt to wait another two to four months before attempting placement. From a long-term perspective, this is the best scenario for ensuring a durable foundation for the implant. It also allows for a socket severely compromised by disease to heal more thoroughly.
To determine which of these placement scenarios is best for you, we'll first need to conduct a thorough dental examination. From there we'll be in a better position to discuss the right implant timeline for your situation. Our main goal is to ensure we can securely place your implant in just the right position to achieve the most successful and attractive result.
If you would like more information on dental implants, 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 “Implant Timelines for Replacing Missing Teeth.”
If you’re in the initial planning stages for a dental implant, you may already be encountering a number of options to consider. One that may come up is how the visible crown will attach to the metal implant imbedded in the bone.
Generally speaking, implants are composed of two parts: a metal post most often made of titanium placed into the bone that serves as the “root” for the new tooth; and a visible, life-like crown made of dental porcelain that attaches to an abutment on the titanium post. The crown can be attached in one of two ways: either with a small screw through the biting surface of the crown into a receiving hole in the abutment or cemented to it.
The major advantage of a screwed crown is that it allows for easy removal of the crown if needed. While the titanium post can often last a lifetime, porcelain crowns more often need repair or replacement since they receive the brunt of the biting forces in the mouth. A screw-attached crown is much easier to remove than a cemented one.
On the other hand, screwed crowns have a small access hole that must be restored with a tooth-colored filling to help the crown appear natural. This isn’t too great an issue with back teeth but does make achieving a natural appearance in the front more difficult. Cemented crowns look more like a natural tooth and are thus more flexible in achieving the desired appearance.
Besides the possibility the cement may cause gum inflammation or bone loss, the chief detraction from cemented crowns is the difficulty in removing them. Crowns are often damaged in this process so it’s highly likely it will have to be replaced rather than repaired. It’s possible to use weaker cement, but this raises the risk of the crown coming loose at some point from the abutment.
As we plan for your implant, we’ll discuss which type of attachment will work best for you, depending on the tooth to be replaced and other conditions with your oral health. The end result, though, should be the same — a new, natural-looking tooth that serves you well for many years to come.
If you would like more information on dental implants, 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 “How Crowns Attach to Implants.”