dr. barrett

Tooth Trauma – Uncomplicated Crown Fracture – What Now?

Tooth trauma can happen at any time. It could happen during a sports game, a car accident or as a result of something as simple and unexpected as a fall. The more information you have about correctly handling these situations the better. This knowledge could very well mean the difference between life and death for the tooth. The goal in treating a tooth trauma case is always to maintain or regain pulpal vitality in the affected tooth/teeth. In the previous tooth trauma entry we covered: avulsion (when a tooth is out of the socket). In this entry we will investigate a different kind of tooth trauma: an uncomplicated crown fracture. In this tooth fracture, the damage is limited to the crown of the tooth. There will be dentin exposed, but no pulp exposure.(1)Tooth Trauma Uncomplicated

In the instance of an uncomplicated crown fracture the first step an individual should try to accomplish is finding the piece of broken tooth. If a saline solution or distilled water is readily available, place the broken piece of tooth in this solution. Once you reach the dental professional, the rehydrated piece of tooth will be easier to bond, as the hydration increases its bonding strength.

What to expect during your visit, following an uncomplicated crown fracture:

  • X-Rays will be taken
  • Mouth will be checked for soft tissue lacerations and the presence of any other foreign bodies
  • A sensitivity analysis will be performed
  • The doctor or staff member will collect the tooth segment from you if you were able to find and preserve it
  • We will assess the prognosis for the tooth

If the tooth is still vital, the process of reattaching the segment of tooth and the subsequent bonding will occur. Filling the dentin wound and applying calcium hydroxide to the vicinity of the pulp is the second to last step. Finally, smoothing and fluoridating small enamel defects.

Stay tuned in the upcoming months for the conclusion of the “What Now?” blog series!

Common Causes of Facial Trauma

Injuries to the face and mouth are emotionally upsetting as well as physically damaging. It’s extremely important to have medical and dental care by experts who know how to address the psychological, medical, and aesthetic elements of recovery. This blog will cover the most common causes of facial trauma and the types of injures that may occur. As with most injuries, prevention is the best medicine, so we will cover tips in avoiding facial trauma all together!

Most Common Causes of Facial Trauma: There are types of facial traumamany ways in which the face can be damaged. Accidents, falls, automobile crashes, work related injuries, and interpersonal violence are among the most common causes for adults. For children, sports related injuries are the leading cause. Children who participate in contact sports, cheerleading, and gymnastics are especially at risk, especially for dental trauma. Dental trauma accounts for 17% of injuries to the body for children, according to the American Dental Association, compared to 5% across all ages. It is most frequently observed in males compared to females, and usually involves the front teeth.

Types of Injuries: Every year about 3 million people are treated for facial trauma according to the American Association of Oral and Maxillofacial Surgeons. Soft tissue trauma includes any cuts to the face or gums. Avulsed, or knocked out teeth are another type of injury, and must be dealt with immediately to increase the chances for reimplantation. Bone injuries, such as fractured jaws, cheekbones, and noses can also occur as well as damage to the nerves in the eyes, face and salivary glands. It is extremely important to have facial trauma assessed and treated by an expert in facial trauma. Besides the aesthetic reasons, serious health complications can occur, even from a small amount of damage. Depending on the location of the injury, speech, swallowing, and breathing can be affected. For dental injury, teeth that are loose in their sockets can make eating difficult and cause speech impediments. Chipped, broken, or misaligned teeth can cause TMJ and other functional problems, in addition to the loss of confidence in your appearance.

What You Can Do to Prevent Injuries: Using a mouthguard during sports or other high-risk activities is the most effective way to prevent injury. Studies in high-risk populations for facial trauma show relatively low compliance in using mouthguards. We can also recommend helmets, face shields, and protective eyewear that can further reduce your risks. The spring season seems to bring an increase of children to the emergency room as kids are eager to get on their bicycles, skateboards, and swing sets. As a parent, educate your child in safety measures and supervise their activity.

When facial trauma does happen, quick action is important. Please call us as soon as possible so we can best advise and support you in your recovery. Accidents happen, and when they do, we want to help!

Grow Your Own Bone? Bone Grafting Is Routine

 

It seems like something out of a science fiction movie, but with our help, you can easily re-grow bone to treat many common disorders in the mouth and make it dental-implant ready! Bone grafting is a common procedure done right in our office. Here is a simple explanation of this effective treatment option.

GrowYourOwnBoneReasons for Bone Grafting. There are many different reasons that a person loses bone support in the jaw. Sometimes it is due to injury, sometimes it because of missing teeth, and other times it is a due to a developmental defect or periodontitis. Bone graft surgery, also called regenerative surgery, is used to replace bone and soft tissue by actually stimulating the body’s natural ability to re-grow the lost tissue.   If your jawbone is inadequate to support dental implants, bone grafting can be used to build a sturdy foundation for implant-supported teeth.

It’s A Natural Process. With bone grafting surgery, a piece of bone is removed from another area of your jaw or your body, often the hip, and is transplanted into your jawbone. Sometimes we may use donor or synthetic graft material. Your body uses the implanted bone graft material as a frame on which it can grow new bone. Over time and with your body’s own healing mechanisms, the grafted bone fuses and becomes an integrated part of your existing bone. Bone grafting is a safe and very successful procedure that can be done in the office under local anesthesia. After the procedure, you will be given antibiotics and pain medication if needed. Swelling can be treated with ice packs applied to your face. Most patients proceed with their normal life the next day. Be sure to follow medication instructions and keep your mouth as clean as possible while you heal.

Healing Times. Healing time following bone grafting depends on the amount of bone loss and the location of the graft area. Maintaining a healthy amount of bone tissue around your teeth is crucial to keeping up your oral health. We are more than happy to explain different materials and techniques that can be used for an optimal outcome.

Bone grafting allows your body to rebuild itself. It can be a great way to restore your natural jaw line and smile. Let us help you decide if bone grafting is the right procedure for you!

Tooth Trauma – Avulsion – What Now?

 

Your son is playing a championship game against the team he’s waited all season to play. The score is tied, and as the minutes wind down, the players have gotten more forceful in their actions. You blink, and all of a sudden your son is holding his mouth and a time-out has been called. You run down to him, and your mind is racing, “What happened? How hurt is he?” As you approach him, you see that in his hand he is holding an adult tooth that has been dislodged from the socket. As the sideline paramedics assess for signs of a concussion or hemorrhage you think, “Now what?”

The injury, and circumstances surrounding the injury may cloud your ability to choose your next action. You can rest assured knowing that when you mix today’s technology and the expertise you can expect from a coordinated team approach, the tooth’s fate is looking brighter already!

In the case of avulsion (when a tooth is out of the socket), the approach will most likely be a team effort. Your first course of action following the injury is to rinse off the tooth and try to place it back in the socket. If this is not possible, place the tooth in milk. If you’re expecting an injury like this (as a coach or school teacher etc. might), have Hank’s BalaToothTraumaWhatNownced Salt Solution on hand to place the tooth in. Water should never be used to place the tooth in. Why milk? Milk maintains the correct fluid balance in the root of the dislodged tooth, which in turn increases the tooth’s chance of survival. Water causes the cells in the tooth to swell and die. If there is no option to place the tooth in any of the approved solutions, place the tooth in between the injured person’s cheek and gum to keep it moist.

After you have arrived at our office, it’s time for us to take over. The investigation phase begins. If a concussion or hemorrhage has not been ruled out, now is the time. When the coast is clear, it is time to move onto a gathering of both radiographic evidence of the injury and clinical documentation about the patient and the incident. From that extracted information, we can make a diagnosis and a subsequent treatment plan. As we mentioned before, depending on the type and severity of the injury, the process may involve a dental professional team.

The aim of treating a tooth trauma case is always to maintain or regain pulpal vitality in the affected tooth/teeth.

In the next few months we will cover other types of tooth injuries and treatments. Stay tuned!

What You Should Know About Jaw Reconstruction Surgery

 

Sometimes jaw problems may require more than orthodontic treatment. Jaw surgery, also known as orthognathic (or-thog-NATH-ik) surgery, can be a great choice for moderate to severe jaw issues. Oral and Maxillofacial Surgeons (OMS) are specially trained in orthognathic surgery that can dramatically improve chewing, speaking, breathing, and in the process enhance a patient’s appearance. If you are considering orthognathic surgery, here are some important things to know.

Why You May Need It. Most conditions that require corrective surgery are the result of abnormal growth of the jaws as they develop. These conditions are often inherited. Other less common causes are facial injury or arthritis of the jaw joints.

Orthognathic surgery may be indicated for the following conditions:

-Difficulty biting, chewing or swallowing food

-Excessive wear or breakdown of teeth

-Chronic jaw or jaw joint pain caused by TMJ (temporomandWhat-to-Know-Jaw-Surgery-2ibular joint disorder) or other jaw problems

-Improve “gummy” smiles, where the lips don’t fully close and show large areas of the gums or “toothless” smiles, where the lips cover all of the teeth

-Facial imbalance, including underbites, overbites, crossbites, and deficient chins

-Sleep apnea

Treatment Team. While we will plan and perform the actual surgery, we will also be working with your dentist and orthodontist for the full course of treatment. Most treatment includes braces for 9 to 18 months before surgery to level and align your teeth. After your jaw heals from surgery, which typically takes about 6 weeks, your orthodontist will finish your alignment and remove the braces. Depending on the severity of your jaw problem, the entire treatment process can take from 12 to 24 months. We know that this is a long-term commitment and we will do our best to minimize the length of treatment and provide you with the best estimates of what will be required.

What to Expect. Jaw surgery can be performed on the upper jaw, lower jaw or both. It is best to perform the surgery after growth stops, usually ages 13 to 15 for females and 16 to 18 for males. Jaw surgery usually can be performed entirely inside your mouth, so no facial scars show. Once your jaws are properly aligned, screws and bone plates secure the bones into their new position. In some cases, extra bone may be added to the jaw. In this case, we transfer the bone from your hip, leg or rib and secure it with temporary wires.

Surgery can take place in an in-patient or outpatient setting, depending on the procedure required. Facial swelling, while variable, is common and increases for a couple of days following surgery before it subsides. More subtle changes in your appearance will continue for up to a year. For this reason, our students generally choose to have the surgery during school vacations. For adults, one to three weeks is usually required before returning to work.

Jaw surgery can enhance your comfort, appearance, and improve your overall health. We are here to answer any questions you have. Please make an appointment for a consultation so we can review the potential of this life changing treatment with you!

Oral Cancer Self-Screening: Why Everybody’s Doing It (Or Should Be)

 

Oral cancer has a bad reputation for being more deadly than some other forms of cancer that you hear of more commonly. We are here to tell you that it doesn’t have to be that way. Oral cancer goes unnoticed, not because it is difficult to see or feel, but because the idea of regular oral cancer screenings (either at home or in our office) is rather new. It simply has not been on the public health radar until now.

That is why we want to get the word out, and we need your help! Examining the neck, throat and oral cavity is a relatively simple task when compared to other parts of the body such as internal organs. Early diagnosis leads to better prognosis!

We recommend that once a month, you give yourself the following exam. It should only take 2-3 minutes and could save your life, or the life of a loved one!

First, a word about the ever-changing mouth: We know that many patients avoid self-exams because the mouth is one area of the body that has constant change going on. For example, you may have a recent burn, bite or cold sore and probably don’t want to bother us every time you notice these things! That is why we offer this rule of thumb: any suspicious area that is not better after 14 days should be brought to our attention.

How to perform an Oral Cancer Self Exam:

  1. Use a mirror and a bright light.
  2. Remove dentures.
  3. Look and feel lips and front of gums. Grasp lips with your thumb and forefinger and feel for lumps.
  4. Tilt your head back and inspect the roof of your mouth
  5. Pull your cheek out to see the inside surface and gums in the rear.
  6. Pull out your tongue and look at all surfaces.
  7. Feel your neck and under the lower jaw for enlarged lymph nodes, swelling or lumps.

What are you looking for?

  1. White patches
  2. Red Patches
  3. Combination of red and white patches
  4. Sores
  5. Abnormal lumps or thickening
  6. Chronic sore throat/hoarseness
  7. Difficulty chewing/swallowing
  8. Masses or lumps in the neck

Facial Injuries: What Do I Do?

It’s important to know what to do when you or someone close to you has been injured, especially when it comes to facial injuries. The inside of your mouth is made up of delicate soft tissues that when cut can become infected and easily damaged if the wound isn’t taken care of quickly. Anyone who has had a facial laceration knows that there is a high degree of emotional and physical pain involved when it comes to a facial laceration. So what should you do?

A laceration is a tear or jagged wound and is usually caused by blunt trauma. If you’ve been in an accident and there is any kind of trauma to your face, it is important to seek emergency assistance right away. Lip lacerations are one of the most common types of facial injuries and require careful repair. LaceratioFacial-Injuriesns are closed using silk or gut sutures and are done carefully in order to prevent any cosmetic damage. If a tooth is knocked out you should place it in salt water or milk as soon as possible. The sooner the tooth is placed back into the dental socket, the better chance it has of surviving. Do not clean or wipe off the tooth since there are crucial parts of the tooth that could become damaged.

Replanting teeth and treating tooth fractures can be handled by an oral surgeon along with facial trauma but if you have been involved in a serious accident you should go to the closest hospital emergency room as soon as possible. Facial bone fractures cannot be treated with a cast like other parts of the body. The surgical placement of plates around the affected area is a recent development in medicine that allows for a faster recovery time and involves the fewest incisions necessary.

Any kind of traumatic injury to your face is serious and should be addressed immediately to prevent further damage and scaring. If you’ve had a recent injury and think you may have a facial bone fracture, call us immediately to schedule a consultation.

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