Posts for: May, 2019
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
As spring weather heats up, so do a lot of outdoor sports like baseball or soccer. Unfortunately, the chances of sports-related injuries increase as well. Your child’s mouth in particular is a prime target for injury—and you need to be prepared.
First and foremost, players should wear a mouthguard during contact sports to reduce their risk of injury. Mouthguards can absorb much of the force generated during impact—and may make the difference between minor bruising and a fractured or knocked-out tooth.
“Boil and bite” mouthguards available from the local pharmacy or sporting goods store are popular because of their cost and availability. These are softened in hot water before the wearer bites down to create a semi-customized fit. An even better option, though, is a custom mouthguard that is made from a precise impression of your child’s teeth that we take in our office. This type of mouthguard costs more, but it provides greater protection and comfort than one from your corner store.
A mouthguard can significantly reduce the risk of injury but won’t eliminate it entirely. If a dental injury does occur, you need to know what to do. This will depend mainly on the type of injury: If the tooth is chipped but not pushed out of position, you can collect any tooth fragments and see us within 12 hours for an examination and possible repairs. If the tooth has moved or is loose, you should see us even sooner—within 6 hours so we can readjust the tooth and, if needed, splint it until it is securely reattached.
A more serious injury is a tooth that has been knocked completely out of its socket. It can often be saved, but you’ll need to act quickly—optimally, within 5 minutes—by reinserting the tooth in its socket. Although it sounds daunting, it’s really a matter of a few simple steps: First, find the tooth and rinse off any debris with clean water. Holding it by the crown (the visible part you are used to seeing) insert the root end into the empty socket. If your placement isn’t “just right,” don’t worry; we can adjust it later, but it will require some pressure to place it in the socket. Have the person bite down on a piece of gauze or clean cloth to hold the tooth in place. Call us immediately. If you cannot reach us, go to an emergency room.
Quick action and prompt follow-up dental care after a mouth injury increase the chance of a happy outcome. Along with proper mouthguard protection, remembering these pointers will help ensure that your family has an enjoyable sports season this year!
If you would like more information about sports-related dental injuries, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Athletic Mouthguards” and “The Field-Side Guide to Dental Injuries.”
There's no doubt treating dental problems can improve your health. But because the mouth is among the most sensitive areas of the body, many dental procedures can be potentially uncomfortable after treatment.
We rely on pain medication to alleviate any dental work discomfort, especially during recuperation. Our arsenal of pain-relieving drugs includes strong opioid narcotics like morphine or oxycodone which have effectively relieved dental pain for decades. But although they work wonders, they're also highly addictive.
We've all been confronted in the last few years with startling headlines about the opioid addiction epidemic sweeping across the country. Annual deaths resulting from opioid addiction number in the tens of thousands, ahead of motor vehicle accident fatalities. Although illegal drugs like heroin account for some, the source for most addiction cases—an estimated 2 million in 2015 alone—is opioid prescriptions.
Dentists and other healthcare providers are seeking ways to address this problem. One way is to re-examine the use of opioids for pain management and to find alternative means that might reduce the number of narcotic prescriptions.
This has led to new approaches in dentistry regarding pain relief. In a trend that's been underway for several years, we've found managing post-discomfort for many procedures can be done effectively with non-steroidal anti-inflammatory drugs (NSAIDs) like aspirin, acetaminophen or ibuprofen. They don't share the addictive quality of narcotics and are regarded as safer when taken as directed.
There's also been a recent modification with using NSAIDs. Dentists have found that alternating the use of ibuprofen and acetaminophen often amplifies the pain relief found using only one at a time. By doing so, we may further reduce the need for narcotics for more procedures.
The trend now in dentistry is to look first to NSAIDs to manage pain and discomfort after dental work. Narcotics may still be used, but only in a secondary role when absolutely needed. With less narcotic prescriptions thanks to these new pain management protocols, we can reduce the risk of a dangerous addiction.