Posts for tag: dental injury
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.”
Contrary to what you might think, a knocked out tooth doesn’t inevitably mean tooth loss. Time is of the essence — the shorter the interval between injury and replanting the tooth, the better the tooth’s long-term survival. The longer the interval, on the other hand, the less likely the tooth can survive beyond a few years. That phenomenon is due to the mouth’s natural mechanism for holding teeth in place.
The tooth root maintains its attachment with the jaw bone through an intermediary tissue known as the periodontal ligament. Tiny fibers from one side of the ligament securely attach to the tooth root, while similar fibers attach to the bone on the opposite side of the ligament. This maintains stability between the teeth and bone while still allowing incremental tooth movement in response to mouth changes like tooth wear.
While the ligament fibers will attempt to reattach to a replanted tooth’s root, the longer the tooth is out of the socket the less likely the fibers will fully reattach. An “ankylosis” may instead form, in which the root attaches directly to the jaw bone without the periodontal ligament. In this situation the body no longer “recognizes” the tooth and begins to treat it like a foreign substance. In all but the rarest cases, the tooth root will begin to resorb (dissolve); at some point (which varies from patient to patient) the attachment becomes too weak for the tooth to remain in place and is lost.
Ideally, a knocked out tooth should be replanted within 5 minutes of the injury (for step-by-step instructions, refer to The Field-Side Guide to Dental Injuries available on-line at www.deardoctor.com/dental-injuries). Even if you pass the 5-minute window, however, it’s still advisable to attempt replanting. With a subsequent root canal treatment (to remove dead tissue from the inner tooth pulp and seal it from infection), it’s possible the tooth can survive for at least a few years, plenty of time to plan for a dental implant or similar tooth replacement.
If you would like more information on treatment for a knocked out tooth, 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 “Knocked Out Tooth.”
It might seem that adults who play aggressive, high-contact professional sports (ice hockey, for example) have the highest chance of sustaining dental injuries. But for many — like NHL hall-of-famer Mike Bossy — their first injured teeth came long before they hit the big time.
“The earliest [dental injury] I remember is when I was around 12,” the former New York Islanders forward recently told an interviewer with the Huffington Post. That came from a stick to Bossy's mouth, and resulted in a chipped front tooth. “Unfortunately, money was not abundant back in those days, and I believe I finally had it repaired when I was 16.” he said.
You may also think there's a greater chance of sustaining dental trauma from “collision sports” like football and hockey — but statistics tell a different story. In fact, according to the Academy of General Dentistry (AGD), you (or your children) are more likely to have teeth damaged while playing soccer than football — and basketball players have a risk that's 15 times higher than football players.
So — whether the game is hockey, basketball or something else — should you let the chance of dental injury stop you or your children from playing the sports they love? We think not... but you should be aware of the things you can do to prevent injury, and the treatment options that are available if it happens.
Probably the single most effective means of preventing sports-related dental injuries is to get a good, custom-made mouth guard — and wear it. The AGD says mouthguards prevent some 200,000 such injuries every year. And the American Dental Association says that athletes who don't wear mouthguards are 60 times more likely to sustain harm to the teeth than those who do.
Many studies have shown that having a custom-fitted mouthguard prepared in a dental office offers far greater protection then an off-the-shelf “small-medium-large” type, or even the so-called “boil and bite” variety. Using an exact model of your teeth, we can fabricate a mouthguard just for you, made of the highest-quality material. We will ensure that it fits correctly and feels comfortable in your mouth — because if you don't wear it, it can't help!
But even if you do have an injury, don't panic: Modern dentistry offers plenty of ways to repair it! The most common sports-related dental injuries typically involve chipped or cracked teeth. In many cases, these can be repaired by bonding with tooth-colored composite resins. For mild to moderate injury, this method of restoration can produce a restoration that's practically invisible. It's also a relatively uncomplicated and inexpensive procedure, which makes it ideal for growing kids, who may elect to have a more permanent restoration done later.
If you have questions about mouthguards or sports-related dental injuries, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Athletic Mouthguards,” and “An Introduction to Sports Injuries & Dentistry.”
Tooth decay and other oral diseases aren’t the only dangers your teeth face — accidental injuries also pose a risk. Fortunately, much can be done to save injured teeth, if you act quickly.
Dental injuries where part of the enamel crown has chipped off are the most common. Even if only one tooth appears damaged, adjacent teeth and bone might also have been damaged internally. Most chip injuries can be repaired either by reattaching the broken crown or with a tooth-colored filling or veneer. If the damage has extended into the inner tooth pulp then a root canal treatment might ultimately be necessary.
Teeth that have been knocked loose from normal alignment (dislodged) or where the entire tooth with its root has separated from the socket (avulsed) are rare but severe when they occur. It’s imperative to see a dentist as soon as possible — even more than five minutes’ of elapsed time can drastically reduce the tooth’s survivability. Dislodged teeth are usually splinted to adjacent teeth for several weeks; we would then carefully monitor the healing process and intervene with endodontic treatment (focused on the tooth’s interior) should something unfavorable occur.
With the possible exception of a primary (baby) tooth, an avulsed tooth should be placed back in the socket as soon as possible. This can be done by someone on scene, as long as the tooth is handled gently, the root not touched, and the tooth rinsed with cold, clean water if it has become dirty. If no one is available to do this, the tooth should be placed in milk to avoid drying out the root, and the patient and tooth transported to a dentist immediately. Once in the socket, the treatment is similar as for a dislodged tooth with splinting and careful watching.
The damaged tooth should be checked regularly. Your body’s defense mechanism could still reject it, so there’s a danger the root could be eaten away, or resorbed. Some forms of resorption can’t be treated — the aim then is to preserve the natural tooth for as long as possible, and then replace it with a life-like restoration to regain form and function.
If you would like more information on the treatment of injured teeth, 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 “Trauma & Nerve Damage to Teeth.”