My Blog

Posts for tag: dental injury

By Patrick H. Collins, PC
November 12, 2014
Category: Oral Health
Tags: oral health   dental injury  
TheTimeIntervaltoReplantaKnockedOutToothCanAffectitsLongevity

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.”

By Patrick H. Collins, PC
April 02, 2014
Category: Dental Procedures
DiagnosingtheExactInjuryisKeytoTreatingJawPain

Your lower jaw is an integral part of eating, speaking and other tasks involving the mouth. But what happens if you suffer an injury to one of the two joints that connect it to the skull? The result could be serious pain and the inability to bring the upper and lower teeth together properly.

The exact types of injuries causing the pain and disability can vary, like the displacement of a tooth or a group of teeth. Another is swelling in the joint space that prevents the head of the joint (the condyle) from fully seating in the joint space; you could also experience a joint dislocation as the condyle is forced completely out of the joint space. Either swelling or dislocation can prevent the back teeth on the side of the affected joint from fitting together properly.

Another traumatic injury is a fracture of the bone at or near the joint; one of the most common is known as a “sub-condylar” fracture where the break occurs just below the condyle and results in more severe pain than inflammation or dislocation. A more serious fracture may involve the joint itself.

To treat the symptoms properly, it’s important to determine which of these injuries has occurred. This requires a full examination, including x-ray imaging, to determine if the injury involves soft tissue, bone or both. In the case of inflammation, we would prescribe anti-inflammatory and muscle relaxant medication. The latter is especially helpful because trauma often leads to muscle spasms that lock the jaw in place to reduce further damage (nature’s splint, if you will). A dislocation may also require gentle manipulation to seat the condyle back into the joint.

Fractures are treated generally by repositioning the broken portions of the bone into their normal position and then immobilizing them while they heal. Immobilization is accomplished by joining the upper and lower teeth together, either by external or internal means. The latter option requires a surgical procedure.

If you’ve suffered an injury that results in any of these symptoms you should contact our office immediately. Only a complete diagnosis can point the way to the proper treatment that will relieve your discomfort.

If you would like more information on the causes and treatment of jaw pain, 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 “Jaw Pain — What’s the Cause?

FourQuestionsAboutTreatingTraumaticInjuriestoTeeth

As the Boy Scouts say, it's best to be prepared. You may never have a traumatic injury to your teeth. But what if you do? Here are four questions and answers about such injuries and their treatment that may be helpful some day.

What are traumatic injuries?
We are talking about physical damage caused by a fall, an accident, or a blow to the face. The word trauma comes from the Greek root meaning “wound.”

A traumatic injury can also cause broken, cracked, or split teeth, or a fracture to the root of the tooth. A tooth may be dislodged from its proper position, pushed sideways, out of or deeper into its socket. It may even be completely knocked out of your mouth.

What should you do if your tooth is knocked out?
With proper treatment, the tooth can be restored to its original place. You must handle the tooth gently and seek professional help as soon as possible. Rinse the tooth in cold water if it is dirty, but do not use any cleaning agent. Avoid touching the root. While hurrying to your dentist, keep the tooth from drying out by keeping it in a container of milk or of your saliva, or by holding it in your mouth between gum and cheek. It is vital to keep the tooth's living tissues moist until it can be professionally assessed and replanted in its socket. If a tooth has been dislodged but not knocked out, it must be repositioned in its socket and may be stabilized with a splint.

Who can treat a tooth that is damaged by a traumatic injury?
A general dentist, an oral surgeon or an endodontist is trained to treat such injuries. An endodontist is trained to treat the root canal(s) inside a tooth. The word comes from “endo” the Greek word for “inside,” and “odont,” the word for “tooth.” After a tooth is replaced in its socket and stabilized, root canal treatment is often needed.

What is root canal treatment?
A tooth is composed mostly of dentin, a living tissue. The top part or crown is covered by hard mineralized enamel. The soft tissue inside the tooth, the pulp, contains blood vessels, nerves and connective tissues. It extends from the crown to the tip of the roots. Treatment of dental pulp injuries is called root canal or endodontic treatment and is usually needed to treat teeth that have been dislodged or fractured.

Contact us today to schedule an appointment to discuss your questions about injuries to teeth and related nerve damage. You can also learn more by reading the Dear Doctor magazine article “/?&issue=issue11&startid=64" onclick="window.open(this.href, '', 'top=1,left=1,width='+screen.availWidth+',height='+screen.availHeight+',toolbar=no,location=no,location=0,directories=no,status=yes,menubar=no,scrollbars=yes,resizable=yes');return false;">Trauma & Nerve Damage to Teeth.”