Dental Emergencies

Post by: Gerarda on 09 Sep 2019

Broken front teeth, tooth pain, knocking out a tooth (avulsed tooth), bleeding gums and tooth sensitivity have all been covered in previous blogs. Below are many other types of dental emergencies that patients have.

Realigned your teeth after a fall
Once your permanent teeth grow in your teeth should never be loose. If you fall and hit your mouth and move teeth out of position, they will become loose and need immediate treatment. A trauma so severe as to move teeth needs emergency room treatment at a hospital to determine if you have had a concussion or a broken jaw. Your first stop though should be your dentist as the sooner the teeth are realigned the better chance they will survive the trauma.

Under some conditions it is possible to move teeth back into place. The dentist administers a local anesthetic, repositions the teeth and then uses composite to bond them to the neighboring teeth for support. This keeps them in place until they heal back into the bone. Depending on the extent of the injury the bonding will have to remain in place for up to 3 months. The longer the teeth are left untreated the harder it will be to move them back into position. Teeth that have moved and caused bone damage will most likely need to be extracted.

Root canal treatment will need to be done on the injured teeth as the nerve will die from the trauma and will cause infection; therefore, the canals have to be cleaned, disinfected and medication placed in the canals or the teeth will start to go dark, a sure sign the nerve is dying.

The teeth stand a better chance of long term viability the sooner they are treated. Seek immediate dental treatment.

Infections
Infections can result in varying degrees of pain and sometimes they can have no pain at all, but all have one thing in common. There is something wrong in your mouth and it needs to be treated sooner rather than later. Whether it is a tooth abscess, cavity, injury, prior dental work or poor oral hygiene, left untreated will only become more serious.

Idiopathic ulcers or canker sores
While idiopathic ulcers are not life threatening, they are very painful and make eating and talking difficult. They develop on the soft tissue or at the base of the gum and are small, oval in shape with a red edge. Most go away in a week or so. Their cause is unknown but researchers believe they develop after a mouth injury such as an accidental cheek bite, hard teeth brushing, food sensitivities or stress to name a few. Contact your dentist if it doesn´t heal or it gets progressively worse.

Abscess
There are three types of abscesses, a periapical abscess, a periodontal abscess, and a gingival abscess. Abscesses occur at different regions of the tooth and for different reasons. Essentially, an abscess is a pocket of pus that is caused by a bacterial infection. Either way you slice it, the abscess need to be treated. The abscess has to be drained to get rid of the infection. At times a root canal treatment is required and if that is not possible then the tooth would need to be pulled. Infection causes bone destruction so it is important for it to be treated in a timely manner. It also can result in serious and sometimes life-threatening complications if left untreated.

Swelling
Swelling in the oral cavity is a common dental emergency and depending on the reason for the swelling is one that needs immediate attention. Usually the swelling doesn´t go away on its own. Swelling of any kind is never a good sign and can indicate that you have a serious dental infection.

A swelling has many causes including:
Gum disease
Gum inflammation (gingivitis)
Using a dental device such as braces
Having a sharp or broken tooth
Reaction to certain foods or medication
Biting your tongue or cheek
Cancer treatment such as chemotherapy or radiation
Taking medication for rheumatoid arthritis, epilepsy or antibiotics
Autoimmune diseases such as lupus, Crohn´s disease or Bechet’s disease

It is not pleasant realizing that you have something wrong in your mouth and it is difficult to examine yourself. You are left wondering if this will go away on its own. Can I look after this myself? How long do I wait before calling my dentist? Many times people have favorite home remedies that can help, but at other times you need to call your dentist immediately.

1. Broken front teeth from diving into a pool or from falling down
Remember while it might be irritating and unattractive, a broken tooth is usually not life-threatening. Depending on how much of your tooth is broken and the angle it is broken at, the treatment could range from doing a composite repair for a chipped tooth to doing a root canal treatment and a crown if the tooth is broken off at the margin of the gum. If the tooth is chipped then schedule an appointment at your convenience; if however, the tooth has broken off or you have pain then see a dentist immediately.

2. Tooth pain
Usually a dental emergency will have a degree of pain attached. It just depends on the level of pain and the kind of pain how your dentist deals with it. If it is sensitive to both cold and hot temperatures, chances are it is a grinding problem. If it is only sensitive to cold, many times, but not always, it could be a nerve problem. It could be that the nerve has been irritated and is crying out for attention. If that is the case you need to call your dentist immediately. It doesn´t get better by itself. If it hurts when you bite down, it could be a broken tooth, it could also mean that you have been grinding your teeth or it could be a sign that you have an abscess. Either way, you need to have it treated by a dentist.

3. You´ve knocked out your tooth
If for whatever reason your tooth gets knocked out, put it back in. Yes put it back in the socket. And hold it there until you see a dentist. Make sure though when you pick it up you only touch the crown of the tooth, the part that is used to chew and not the root. Also important is to put it back in the correct position. If there is any debris on the tooth when you pick it up rinse it in a cup of lukewarm tap water for no more than 10 seconds. Any longer than that can kill the cells on the root surface that help reattach it. If you are looking at your tooth between your fingers then most probably you´re in shock, but if you want to save the tooth then you have to remain calm and think. If you can´t put it back correctly, then put it in a glass of milk. If milk is not an option, then put it in your mouth between the cheek and the gum to keep it moist. Do not swallow it as you only have about 2 hours for it to be reimplanted correctly. The sooner the better, otherwise, the likelihood of success becomes less. You need to make a very quick trip to a dentist.

For most dental emergencies you need to go to a dental clinic not a hospital. Hospitals rarely have a dental department and if they do it is even rarer that there would be someone on call. A doctor in an emergency room can only give you pain medication or antibiotics. In some cases, they will schedule an x-ray or scan depending on the severity of the trauma. They will still suggest you see your dentist.

Tooth Enamel and Erosion

Post by: Gerarda on 08 Aug 2019

What is tooth enamel?
Tooth enamel is that hard, shiny layer of material which protects your teeth against decay. It is the layer of material that you are to brush and floss on a daily basis. To be more precise, it is hydroxyapatite, a translucent calcium phosphate. Suffice it to say enamel is the hardest mineral element in your body, even harder than bone. Don´t be fooled though as it still can be damaged.

What causes enamel to be damaged or eroded?
• Poor oral hygiene
• Acidic food & drinks (lemon juice, limes, grapefruits, grapes, pineapples, pomegranates, blueberries) to name a few
• Soft drinks in excess
• High sugar and starch diet
• Teeth grinding – wears away the enamel and leaves the dentin exposed
• Medications (antihistamines, decongestants, high blood pressure medications (including diuretics & calcium channel blockers), antidepressants, sedatives, pain medications, antacids
• Dry mouth – xerostomia, where the saliva glands don´t make enough saliva to keep the mouth wet. Many times this is a side effect of medication or radiation therapy.
• Acid reflux that occurs more than a couple of times a week
• Gastrointestinal problems – repeated vomiting from GI problems or eating disorders

What does tooth erosion look or feel like?
When your teeth become rough and irregular, or serrated like a saw blade you know the enamel has eroded. Essentially you reshape your teeth. You can experience sever sensitivity to both cold and hot temperatures and to sweets. You can also feel a shooting pain through one or more teeth so much so that it makes your eyes squint.

Can tooth erosion be repaired?
Once tooth enamel is gone, it´s gone. Teeth need to be rebuilt with composite restorations, crowns or veneers. The advantage of composite restorations is that it is a comparatively inexpensive and a conservative way to restore teeth. The result is immediate. More extensively damaged teeth might necessitate a porcelain veneer or porcelain crown.

You only get one set of permanent teeth; therefore, you might as well look after them. They are not meant to bite off thread or to open a bottle cap in a pinch. Your teeth need to be healthy as they not only serve to make us look good, but they also aid in digestion. As your mouth is the beginning of the digestive system it stands to reason that if you have digestive problems then you look to the overall health of your mouth as well as your stomach to determine the problem.

Begin by looking at your teeth and see whether any of the above symptoms are similar to yours. If they are then you know what to do. Call your dentist for a check-up.

To Bleach or Not to Bleach

Post by: Gerarda on 16 Jul 2019

You are spoiled for choice if you choose to whiten your teeth. There are many approved products on the market both sold at a pharmacy and those available from your dentist. As long as you follow the directions carefully they are both safe. From the wide array of choices many teeth whiteners are fairly effective and do just as it says “on the tin”. You must remember though that it takes an extended period of time for teeth to become noticeably whiter using an over the counter product as it will not contain peroxide, the agent that actually bleaches teeth.

What are your teeth whitening options?

Whitening strips

 

Effectiveness: On average, you can expect to see results in about a week. Naturally this is individual and will depend on the level of teeth discoloration, the amount of teeth staining food and drink you consume and your level of oral hygiene.

Ease of use: Whitening strips are very easy to apply. One treatment is composed of two strips. Teeth whitening strips are good choices for those looking for a fast solution to enhance their smile for a special occasion, but if you are looking for more radical results something more long-lasting may be ideal.

Whitening toothpaste

 

Effectiveness: This appears to whiten teeth slightly by getting rid of stains such as those caused by drinking coffee/tea, smoking or eating tooth staining foods like curry, soy and ketchup. Whitening toothpastes, however, can’t change the natural color of your teeth or lighten a stain that goes deeper than a tooth’s surface. When used twice a day, whitening toothpastes can take anywhere from two to six weeks to make teeth appear whiter, therefore, it is not a dramatic change. Those whitening toothpastes that contain blue covarine can have an immediate effect as the paste adheres to the teeth giving the illusion of whiter teeth.

Ease of use: As one of the simplest options you use it no differently than you would your usual toothpaste. Keep in mind that whitening toothpastes typically contains abrasives that polish the teeth. As whitening toothpastes are typically designed to maximize cleaning and minimize wear on tooth enamel, remember to follow manufacturer recommendations.

If you’re considering using whitening toothpaste, look for a brand that has been approved by the FDA or the EU.

If you want a longer lasting effect and want your teeth to be whiter than toothpaste or whitening strips can deliver, then you might consider Home bleaching or In-office bleaching.

Home Bleaching

Effectiveness: The dentist would first clean your teeth as it is important to start with teeth that do not have calculous or stains. You maximize your bleaching in this way. The dentist then takes an impression of your teeth and uses it to make custom-made trays that fit only your teeth. The customized trays ensure that the bleaching material stays in contact with the teeth, which is necessary for maximum effect. It also prevents saliva from coming into contact with the bleaching material which can dilute it causing it to be less effective.

Ease of use: A small amount of bleaching material is placed in each tray which you then wear for 90 minutes over the span of a week or less, depending on how much lighter you want your teeth. Many people see a difference in their teeth after the first session, but the more you use the gel the lighter your teeth will become. You usually need to bleach for a week or less.

We suggest that you do the bleaching after you have brushed and flossed for the evening and know that you are not going to be eating or drinking anything before going to sleep.

In-office Bleaching

Effectiveness: As above, the dentist needs to be clean the teeth before the bleaching procedure, after which a protective material is placed on the gum line to protect the neck of the tooth from becoming sensitive. Whitening gel is placed on the teeth and then activated by plasma light (a very intense blue light) to help break down the stain in the micro porosities on the teeth.

Ease of use: This is done in a single visit.

Remember teeth whitening is not a permanent fix to lighten teeth. Over time, teeth will become darker again as a normal progression of aging and as a normal process of living. We will continue to eat and drink teeth staining foods like soy, tea, coffee, red wine and curries to name a few. When that happens all you need to do is to repeat the teeth whitening process to bring the teeth back to the color you like.

Bruxism – Teeth Grinding

Post by: Gerarda on 03 Jul 2019

The effects of grinding teeth for many years

Ever wake up with a headache and it wasn´t from overindulging the previous night?

Do you ever experience any of these other symptoms?
• Migraines
• Tinnitus
• Painful facial muscles or jaw joints – TMJ
• Clicking, popping or grating sounds in your jaw
• Painful neck or shoulders
• Earache or a toothache or had many teeth hurting
• Broken or worn teeth

If you have answered yes to one or more of these questions, then you may suffer from a condition called, bruxism.

What is bruxism?
Bruxism is the habit of clenching or grinding ones teeth. This happens in the early part of the night when you are deep asleep. Sometimes it can be loud enough to wake up someone sleeping next to you. With some people they make no sound at all, and it is not until a dentist discovers wear on patient´s teeth that they know they are doing it at all.

What are the signs of bruxism?
Teeth that show signs of wear is one of the most obvious signs of bruxism. The force of the grinding can cause the teeth to break or fracture or even become shorter. It can damage dental restorations or cause veneers to pop off and teeth to become loose, as if the tooth is becoming “extracted”. Prolonged grinding can wear through the layer of dentin and cause teeth to become sensitive to cold and hot.

With lower front teeth you can sometimes see that the teeth have a sharp angle like a ski hill or they become irregular and chipped. The upper front teeth can come to be very thin. The molars or the big teeth can become flat and shiny and have the appearance of a skating rink. As you can tell, excessive grinding takes a toll on teeth.

What causes bruxism?
The causes of bruxism are not conclusive as many factors may be involved. One consistent theme that seems apparent though is that stress plays a big factor. In addition, an unbalanced bite, crooked or missing teeth may also be contributing factors. An unbalanced bite or a bite that feels like teeth are “high” can quickly become a TMJ issue. Furthermore if you don´t have back teeth, then the load is distributed on the front teeth only causing excessive wear on them.

What to do if you suffer from bruxism?
Consult your dentist to find the best solution for you. It could be a night guard that is worn while you sleep that prevents teeth coming into contact if you grind excessively and therefore, relieves some of the pressure of grinding and clenching. You will still grind and clench your teeth, but you will not be wearing away your teeth as you will be biting on the night guard instead.

Night guard

If you have broken teeth or have worn them excessively, they may need reshaping, rebuilding or possibly crowns.

Maybe you need to find ways to relax in your daily routine. It could be time to sit and read that book you have wanted to start, or to listen to your favorite tunes in peace and quiet. A nice warm bath at the end of a day is also a great stress reliever. What is your personal stress reliever? Remember what it is and try to make more time for it.

As continued grinding and clenching wear away the teeth, you might like to think about what is causing it in your own life. Whatever your answer, it is wise to see your dentist to discuss it and see what you can do about it.

Categories: Bruxism,Dental health,Dental Information
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Posted on Wednesday 3rd July 2019 at 8:52 am