If we could go back in time, we all probably have a few things we wish we could change. Recently, Dr. Travis Stork, emergency room physician and host of the syndicated TV show The Doctors, shared one of his do-over dreams with Dear Doctor magazine: “If I [could have] gone back and told myself as a teenager what to do, I would have worn a mouthguard, not only to protect my teeth but also to help potentially reduce risk of concussion.”
What prompted this wish? The fact that as a teenage basketball player, Stork received an elbow to the mouth that caused his two front teeth to be knocked out of place. The teeth were put back in position, but they soon became darker and began to hurt. Eventually, both were successfully restored with dental crowns. Still, it was a painful (and costly) injury — and one that could have been avoided.
You might not realize it, but when it comes to dental injuries, basketball ranks among the riskier sports. Yet it’s far from the only one. In fact, according to the American Dental Association (ADA), there are some two dozen others — including baseball, hockey, surfing and bicycling — that carry a heightened risk of dental injury. Whenever you’re playing those sports, the ADA recommends you wear a high-quality mouth guard.
Mouthguards have come a long way since they were introduced as protective equipment for boxers in the early 1900’s. Today, three different types are widely available: stock “off-the-shelf” types that come in just a few sizes; mouth-formed “boil-and-bite” types that you adapt to the general contours of your mouth; and custom-made high-quality mouthguards that are made just for you at the dental office.
Of all three types, the dentist-made mouthguards are consistently found to be the most comfortable and best-fitting, and the ones that offer your teeth the greatest protection. What’s more, recent studies suggest that custom-fabricated mouthguards can provide an additional defense against concussion — in fact, they are twice as effective as the other types. That’s why you’ll see more and more professional athletes (and plenty of amateurs as well) sporting custom-made mouthguards at games and practices.
“I would have saved myself a lot of dental heartache if I had worn a mouthguard,” noted Dr. Stork. So take his advice: Wear a mouthguard whenever you play sports — unless you’d like to meet him (or one of his medical colleagues) in a professional capacity…
When it's time for your child to visit the dentist (we recommend around their first birthday), you may want them to see your family dentist. But you might also want to consider another option: a pediatric dentist.
The difference between the two is much the same as between a pediatrician and a family practitioner. Both can treat juvenile patients — but a family provider sees patients of all ages while a pediatrician or pediatric dentist specializes in patients who haven't reached adulthood.
Recognized as a specialty by the American Dental Association, pediatric dentists undergo about three more years of additional post-dental school training and must be licensed in the state where they practice. They're uniquely focused on dental care during the childhood stages of jaw and facial structure development.
Pediatric dentists also gear their practices toward children in an effort to reduce anxiety. The reception area and treatment rooms are usually decorated in bright, primary colors, with toys and child-sized furniture to make their young patients feel more at ease. Dentists and staff also have training and experience interacting with children and their parents to help them relax during exams and procedures.
While a pediatric practice is a good choice for any child, it can be especially beneficial for children with special needs. The “child-friendly” environment is especially soothing for children with autism, ADHD or other behavioral/developmental disorders. And pediatric dentists are especially adept in treating children at higher risk for tooth decay, especially an aggressive form called early childhood caries (ECC).
Your family dentist, of course, can presumably provide the same quality care and have an equally welcome environment for children. And unlike a pediatric dentist who will typically stop seeing patients when they reach adulthood, care from your family dentist can continue as your child gets older.
In the end it's a personal choice, depending on the needs of your family. Just be sure your child does see a dental provider regularly during their developing years: doing so will help ensure a lifetime of healthy teeth and gums.
If you would like more information on visiting a pediatric dentist for your child's dental needs, 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 “Why See a Pediatric Dentist?”
A few days before the Oscars, Vanity Fair magazine asked Academy Awards host Neil Patrick Harris to name his most treasured possession. Was it his Tony award statuette for best leading actor in a musical? His star on the Hollywood Walk of Fame? The stethoscope he wore while playing teenaged doctor Doogie Howser on TV? No, as it turns out, the 41-year-old actor’s most treasured possession is… his wisdom teeth. Yes, you read that correctly. “Oddly, I still have my four wisdom teeth,” Harris said. “I refuse to let them go or I’ll lose my wise parts.”
How odd is it for a 41-year-old to have wisdom teeth? Actually, not that odd at all. While it is true that wisdom teeth are often removed, there’s no one-size-fits-all approach to this. It all depends on whether they are causing problems now, or are likely to cause problems in the future.
The trouble wisdom teeth cause is related to the fact that they are the last molars to come in, and that molars are large in size. By the time wisdom teeth appear between the ages of 17 and 21, there often is not enough room for them in the jaw. Sometimes it’s because you may have inherited a jaw size that’s too small for your tooth size; and generally speaking, the size of the human jaw has evolved to become smaller over time.
If room is lacking, the adjacent molar (that came in earlier) can interfere with the path of eruption — causing the wisdom tooth to come in at an odd angle. The wisdom tooth can hit up against that other tooth, possibly causing pain or damaging the adjacent tooth. This is known as “impaction.” Sometimes the wisdom tooth breaks only partway through the gum tissue, leaving a space beneath the gum line that’s almost impossible to clean, causing infection. A serious oral infection can jeopardize the survival of teeth, and even spread to other parts of the body.
If a wisdom tooth is impacted, will you know it? Not necessarily. A tooth can be impacted without causing pain. But we can see the position of your wisdom teeth on a dental x-ray and help you make an informed decision as to whether they should stay or go. If removal is the best course of action, rest assured that this procedure is completely routine and that your comfort and safety is our highest priority. If there is no great risk to keeping them, as Neil Patrick Harris has done, we can simply continue to monitor their condition at your regular dental checkups. It will be particularly important to make sure you are reaching those teeth with your brush and floss, and that you keep to your schedule of regular professional cleanings at the dental office. All healthy teeth are indeed worth treasuring.
If you would like more information about wisdom teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”
X-ray imaging is a routine part of a child's dental care — and it undeniably makes a difference in preventing and treating dental disease. It's so routine, we can easily forget they're being exposed to an invisible form of electromagnetic radiation.Â And just like other sources of radiation, too much x-ray exposure could increase the risk of cancer.
But while it's possible for your child to be over-exposed to x-rays, it's highly unlikely. That's because healthcare professionals like dentists adhere to a standard known as ALARA when considering and administering x-rays. ALARA is an acronym for “as low as reasonably achievable.” In other words, we only want to expose a patient to the lowest and safest levels of x-ray dosage and frequency that will achieve the most benefit.
To achieve that standard, professional dental organizations advocate the use of x-rays only after a clinical examination of the patient, as well as a thorough review of their medical history for any usage of x-rays for other conditions. If x-rays are warranted, we then take further precautions to protect the patient and staff, and only use the type of x-ray application that's absolutely necessary. For most children that will be a set of two or four bitewing radiographs, which are quite effective for detecting decay in back teeth.
This dosage of radiation in a session of bitewing radiographs is roughly a fifth of the background radiation in the environment a child may be exposed to every day. By spacing these sessions at least six months apart, we're able to achieve a high level of decay detection at a safe and reasonable amount of x-ray exposure.
On top of that, the digital advances in x-ray imaging have reduced the amount of radiation energy needed to achieve the same results as we once did with film. These lower exposure levels and the ALARA standard helps ensure your child's exposure to x-rays will be well within safe limits.
If you would like more information on the use of x-rays with children, 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 “X-Ray Safety for Children.”
For anyone else, having a tooth accidentally knocked out while practicing a dance routine would be a very big deal. But not for Dancing With The Stars contestant Noah Galloway. Galloway, an Iraq War veteran and a double amputee, took a kick to the face from his partner during a recent practice session, which knocked out a front tooth. As his horrified partner looked on, Galloway picked the missing tooth up from the floor, rinsed out his mouth, and quickly assessed his injury. “No big deal,” he told a cameraman capturing the scene.
Of course, not everyone would have the training — or the presence of mind — to do what Galloway did in that situation. But if you’re facing a serious dental trauma, such as a knocked out tooth, minutes count. Would you know what to do under those circumstances? Here’s a basic guide.
If a permanent tooth is completely knocked out of its socket, you need to act quickly. Once the injured person is stable, recover the tooth and gently clean it with water — but avoid grasping it by its roots! Next, if possible, place the tooth back in its socket in the jaw, making sure it is facing the correct way. Hold it in place with a damp cloth or gauze, and rush to the dental office, or to the emergency room if it’s after hours or if there appear to be other injuries.
If it isn’t possible to put the tooth back, you can place it between the cheek and gum, or in a plastic bag with the patient’s saliva, or in the special tooth-preserving liquid found in some first-aid kits. Either way, the sooner medical attention is received, the better the chances that the tooth can be saved.
When a tooth is loosened or displaced but not knocked out, you should receive dental attention within six hours of the accident. In the meantime, you can rinse the mouth with water and take over-the-counter anti-inflammatory medication (such as ibuprofen) to ease pain. A cold pack temporarily applied to the outside of the face can also help relieve discomfort.
When teeth are broken or chipped, you have up to 12 hours to get dental treatment.Â Follow the guidelines above for pain relief, but don’t forget to come in to the office even if the pain isn’t severe. Of course, if you experience bleeding that can’t be controlled after five minutes, dizziness, loss of consciousness or intense pain, seek emergency medical help right away.
And as for Noah Galloway:Â In an interview a few days later, he showed off his new smile, with the temporary bridge his dentist provided… and he even continued to dance with the same partner!
If you would like more information about dental trauma, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Trauma & Nerve Damage to Teeth” and “The Field-Side Guide to Dental Injuries.”
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