My Blog

Posts for tag: dental injuries

By John Kelmenson, D.D.S.
February 01, 2020
Category: Oral Health
NHLIronManKeithYandleSuffersDentalTraumaonIce

Professional Hockey player Keith Yandle is the current NHL “iron man”—that is, he has earned the distinction of playing in the most consecutive games. On November 23, Yandle was in the first period of his 820th consecutive game when a flying puck knocked out or broke nine of his front teeth. He returned third period to play the rest of the game, reinforcing hockey players’ reputation for toughness. Since talking was uncomfortable, he texted sportswriter George Richards the following day: “Skating around with exposed roots in your mouth is not the best.”

We agree with Yandle wholeheartedly. What we don’t agree with is waiting even one day to seek treatment after serious dental trauma. It was only on the following day that Yandle went to the dentist. And after not missing a game in over 10 years, Yandle wasn’t going to let a hiccup like losing, breaking or cracking nearly a third of his teeth interfere with his iron man streak. He was back on the ice later that day to play his 821st game.

As dentists, we don’t award points for toughing it out. If anything, we give points for saving teeth—and that means getting to the dentist as soon as possible after suffering dental trauma and following these tips:

  • If a tooth is knocked loose or pushed deeper into the socket, don’t force the tooth back into position.
  • If you crack a tooth, rinse your mouth but don’t wiggle the tooth or bite down on it.
  • If you chip or break a tooth, save the tooth fragment and store it in milk or saliva. You can keep it against the inside of your cheek (not recommend for small children who are at greater risk of swallowing the tooth).
  • If the entire tooth comes out, pick up the tooth without touching the root end. Gently rinse it off and store it in milk or saliva. You can try to push the tooth back into the socket yourself, but many people feel uneasy about doing this. The important thing is to not let the tooth dry out and to contact us immediately. Go to the hospital if you cannot get to the dental office.

Although keeping natural teeth for life is our goal, sometimes the unexpected happens. If a tooth cannot be saved after injury or if a damaged tooth must be extracted, there are excellent tooth replacement options available. With today’s advanced dental implant technology, it is possible to have replacement teeth that are indistinguishable from your natural teeth—in terms of both look and function.

And always wear a mouthguard when playing contact sports! A custom mouthguard absorbs some of the forces of impact to help protect you against severe dental injury.

If you would like more information about how to protect against or treat dental trauma or about replacing teeth with dental implants, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Dental Implants: A Tooth-Replacement Method That Rarely Fails” and “The Field-Side Guide to Dental Injuries.”

By John Kelmenson, D.D.S.
February 19, 2015
Category: Oral Health
RepairingChippedTeeth

Your son just crashed his skateboard and cracked a tooth, or maybe your daughter fell off the monkey bars at school and now has a chipped front tooth. For children, and some adults, repairing chipped or damaged teeth with tooth-colored restorative materials directly bonded to the teeth may be the perfect solution to restore their smiles.

What is Involved: Composite bonding is a technique that has been developed to correct chipped teeth and other minor dental imperfections. It may also be used to correct mild crookedness or gaps between teeth. The procedure requires the application of a tooth-colored composite resin material to the surfaces of teeth, which is then sculpted to the desired shape. It can be performed in a single visit for one or multiple teeth. The procedure usually takes between one and two hours, and the end result is a beautiful, natural-looking smile.

Advantages for Kids and Adults: Composite resin bonding is a good choice for kids and teens since their jaws are still growing and developing, and they may still be engaged in high-risk activities. After your child's teeth and jaws are fully developed, we can discuss options for more permanent restorations such as porcelain veneers or crowns. These require removal of more tooth structure, which could compromise the long-term health of your child's teeth if done too soon. Composite resin restorations, which bond straight to the teeth and require little to no tooth preparation or drilling are therefore a good option for fixing chipped teeth, and they're less expensive than choosing veneers.

Disadvantages: The longevity of composite resin restorations is related to how well you maintain your teeth. Many people can go for ten or fifteen years before they need to have the bonded resins repaired or replaced. Others will tend to stain and wear after only one or two years and will need some touch-up work.

Contact us today to schedule an appointment to discuss any questions you may have regarding dental bonding. Read more about this topic in the Dear Doctor magazine article “Repairing Chipped Teeth.”

By John Kelmenson, D.D.S.
February 11, 2015
Category: Dental Procedures
Tags: root canal   dental injuries  
SevereDentalInjuriesMayRequireEndodonticTreatment

If you regularly participate in sports or other physical activity, you’re at a higher risk for dental injuries. While chipped teeth are the most common result of these injuries, a few may result in more serious trauma — dislodged, cracked or knocked out teeth. In these cases, the core of the tooth — the pulp — and the root may have been damaged. Saving the tooth may require endodontic treatment and possibly the expertise of a specialist in the field, an endodontist.

Endodontics, from the Greek words for “within” and “tooth,” is a specialty of dentistry that treats disease or damage affecting the inner parts of a tooth, particularly the pulp chamber, the root canals, and the root. While all dentists are trained in endodontic procedures, an endodontist has advanced training, experience and specialized equipment to address complex cases.

The type of endodontic treatment needed for an injured tooth will depend on the extent of damage. A mature, permanent tooth with pulp damage, for example, may require a root canal treatment. In this procedure the pulp chamber and root canals are thoroughly cleaned out, and then are filled with a special filling to prevent any future infection. Later the tooth should be crowned to permanently seal it. Although a general dentist may perform a root canal, more complex cases, such as a tooth with an extensive root canal network, may need to be performed by an endodontist using microscopic equipment.

A tooth that has undergone severe trauma, especially a knocked out tooth, will need extensive follow-up care by a general dentist and possibly an endodontist to improve its chances of long-term survival. Because of the severity, the tooth may lose viability and the body ultimately may begin to reject it. For this reason, the tooth should be monitored on a regular basis and may need further treatment from time to time, even up to five years after the injury.

One final word: if you participate in sports or exercise activity, you can significantly reduce your risk of dental injury with a mouthguard. There are various types, but the best protection is one custom designed to fit the specific contours of your mouth. We’ll be glad to advise you further on how to protect your teeth from injury.

If you would like more information on dental injury prevention and treatment, 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.”

By John Kelmenson, D.D.S.
September 25, 2013
Category: Oral Health
Tags: dental injuries  
TimingisEverythingWhenitComestoTreatingMouthInjuries

When you or a family member takes a traumatic hit to the mouth, what should you do? Besides immediate first aid, your next action will depend on the extent of damage to any teeth. What you do and when you do it may even determine whether an injured tooth is eventually saved or lost.

If a tooth has been completely knocked out, you have about five minutes to replace the tooth in the socket to give it the best chance of reattachment and long-term survival. While we can certainly perform this action in our office, getting to us within five minutes may not be possible. Fortunately, any person can perform this action on site (see the article linked below for basic instructions on replantation). If for some that's not possible, you should control bleeding at the tooth site with direct pressure, place the recovered tooth in milk or the patient's saliva, and see us as soon as possible.

If, however, the injured tooth has been obviously knocked out of line but not completely detached from its socket, you have a small cushion of time to seek dental treatment — but not much. For this degree of injury, you should see us within six hours of the incident. We will be able to determine the exact nature of the injury, and treat the condition by moving the teeth back into proper position and splinting them.

You have up to twelve hours for broken or chipped teeth still in their normal position. Try to locate and save any broken-off fragments — it may be possible to re-bond them to the teeth. Although it may not be as urgent as other situations, you should still seek treatment as soon as possible. A broken tooth could leave the inner pulp exposed — a situation that left untreated could lead to eventual tooth loss.

Traumatic injuries to the mouth can have serious consequences for your long-term dental health. With our consultation and treatment efforts, we can help you save an injured tooth.

If you would like more information on caring for dental injuries, 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 “The Field-Side Guide to Dental Injuries.”

MouthguardsareYourBestProtectionAgainstSports-RelatedDentalInjuries

Whether you are a serious or “weekend” athlete, you know the importance of protecting yourself against injury. While looking after your joints, ligaments and bones may garner most of your attention, you shouldn't neglect looking after your teeth and mouth as well. In fact, there are more than 600,000 emergency room visits each year for sports-related dental injuries. A knocked out tooth could eventually cost you $10,000 to $20,000 in dental treatment during your lifetime.

The best protection is really quite simple — wear a properly-fitted athletic mouthguard. Researchers estimate that mouthguards may prevent more than 200,000 dental injuries annually. Be aware, though — not all mouthguards are alike or provide the same level of protection.

Mouthguards generally fall into three types. Stock mouthguards are the least expensive of the three, and also the least effective at protection. They come in limited sizes and can't be customized to the wearer. “Bite and Boil” mouthguards are made of thermoplastic that becomes pliable when heated (as when boiled in water). In this state the mouthguard can be pressed into the wearer's teeth, which hardens to that fit once the thermoplastic cools. However, the fit isn't exact and they don't always cover the back teeth. Also during the heat of competition, the mouthguard softens and loses some of its stability and protection.

While more expensive than the other two types, a custom-fitted mouthguard made by a dentist provides the best level of protection. Made of a tear-resistant material, they are more comfortable to wear than the other types and cover more of the interior of the wearer's mouth.

A properly fitted and worn mouthguard protects the mouth and jaw area in a number of ways. It cushions the soft tissue of the lips and gums from cuts and abrasions caused by contact with sharp teeth surfaces after an impact. It absorbs and distributes forces generated in an impact that can cause tooth loss or even jaw fracture, and also cushions the jaw joint (TMJ) to reduce the likelihood of dislocation or other trauma.

A custom-fitted mouthguard can cost hundreds of dollars, but that price is relatively small compared with the physical, emotional and financial price you'll pay for an injury. This investment in your oral health is well worth it.

If you would like more information on the use of athletic mouthguards, contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Athletic Mouthguards.”