Even though teeth are resilient, they're not indestructible. An accidental collision involving the face could damage teeth, even knocking a tooth completely out of its socket.
At first, it might seem like the end of the line for that particular tooth. But it doesn't have to be—if you know what to do. But you'll have to act quickly: The longer the tooth is out of its socket, the less chance it will survive long-term.
Here are the steps you should take to save a knocked-out tooth.
Find the tooth. It's important that you locate the missing tooth quickly. When you do, don't handle it by the root end: It still contains delicate periodontal cells that are essential if the tooth is going to rejoin with the ligaments and bone. Use clean water to rinse off any dirt or debris.
Reinsert the tooth. Holding it by the crown and not the root, reinsert the tooth into its empty socket, hopefully within an hour (the faster the better). You want to make sure it's good and snug, so apply a little force when you do this. Place some clean gauze or cloth between the tooth and its opposite on the other jaw, then have the person bite down and hold it in place.
Get immediate dental care. It's preferable to find a dentist as soon as possible (if not, then the nearest emergency medical facility). The dentist will x-ray the tooth to make sure it's positioned properly, and may adjust it further if necessary. They may also splint the tooth to adjacent teeth to help stabilize it until it fully reattaches with the jaw.
Again, time is of the essence—the quicker you can perform the above steps, the better the tooth's chances. Any delay could jeopardize the tooth's ability to reattach, or it could shorten its lifespan.
You can also get guidance on treating a knocked-out tooth and other dental emergencies with a free mobile app developed by the International Association of Dental Traumatology (IADT). Just look in your Android or IOS app store for ToothSOS.
If you would like more information on what to do during a dental emergency, 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 “When a Tooth is Knocked Out.”
All crowns are designed to restore functionality to a damaged tooth. But crowns can differ from one another in their appearance, in the material they’re made from, and how they blend with other teeth.
A crown is a metal or porcelain artifice that’s bonded permanently over a decayed or damaged tooth. Every crown process begins with preparation of the tooth so the crown will fit over it. Afterward, we make an impression of the prepared tooth digitally or with an elastic material that most often is sent to a dental laboratory to create the new crown.
It’s at this point where crown composition and design can diverge. Most of the first known crowns were made of metal (usually gold or silver), which is still a component in some crowns today. A few decades ago dental porcelain, a form of ceramic that could provide a tooth-like appearance, began to emerge as a crown material. The first types of porcelain could match a real tooth’s color or texture, but were brittle and didn’t hold up well to biting forces. Dentists developed a crown with a metal interior for strength and a fused outside layer of porcelain for appearance.
This hybrid became the crown design of choice up until the last decade. It is being overtaken, though, by all-ceramic crowns made with new forms of more durable porcelain, some strengthened with a material known as Lucite. Today, only about 40% of crowns installed annually are the metal-porcelain hybrid, while all-porcelain crowns are growing in popularity.
Of course, these newer porcelain crowns and the attention to the artistic detail they require are often more expensive than more traditional crowns. If you depend on dental insurance to help with your dental care costs, you may find your policy maximum benefit for these newer type crowns won’t cover the costs.
If you want the most affordable price and are satisfied primarily with restored function, a basic crown is still a viable choice. If, however, you would like a crown that does the most for your smile, you may want to consider one with newer, stronger porcelain and made with greater artistic detail by the dental technician. In either case, the crown you receive will restore lost function and provide some degree of improvement to the appearance of a damaged tooth.
Restoring chipped, stained or decayed teeth with dental porcelain is a tried and true method that’s been used for decades. In recent years, though, restorations made with composite resin have become a popular alternative.
Made of a plastic-based matrix with added glass filler, composite resin can be molded and bonded to teeth to replace missing structure with color to match. While they can’t be used for every problem situation, they’re an efficient and economical way to transform your smile.
Here are 4 advantages for using composite resin to restore moderately defective teeth.
They require very little tooth preparation. Crowns, veneers and other porcelain restorations require removing some healthy tooth structure to accommodate them. With the development of stronger bonding materials, composite resins can restore even many large defects in teeth caused by decay or trauma with little structural removal and still remain durable.
Most composite resin restorations are “single-visit” procedures. Unlike porcelain restorations, applying composite resin doesn’t require a dental lab, a process that can take multiple visits. In most cases, a skilled dentist can apply them during a single visit.
They have excellent color matching capabilities. We usually think of teeth as one single shade of white — actually, a single tooth can have varying gradations of color from the root to the tip. As mentioned before, composite resins can be prepared to match those color shades precisely, so your restored teeth look natural and blend well with your other teeth.
Composite resins can be an effective temporary fix for young injured teeth. Because children’s teeth are still developing, permanent restorations for traumatized teeth aren’t usually advisable until they’ve fully matured. Composite resin can be used to restore a young tooth’s form and function until it’s ready for a permanent solution.
If you would like more information on restoring teeth with composite resin, 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 “Artistic Repair of Front Teeth with Composite Resin.”
You probably wouldn't be surprised to hear that someone playing hockey, racing motocross or duking it out in an ultimate fighter match had a tooth knocked out. But acting in a movie? That's exactly what happened to Howie Mandel, well-known comedian and host of TV's America's Got Talent and Deal or No Deal. And not just any tooth, but one of his upper front teeth—with the other one heavily damaged in the process.
The accident occurred during the 1987 filming of Walk Like a Man in which Mandel played a young man raised by wolves. In one scene, a co-star was supposed to yank a bone from Howie's mouth. The actor, however, pulled the bone a second too early while Howie still had it clamped between his teeth. Mandel says you can see the tooth fly out of his mouth in the movie.
But trooper that he is, Mandel immediately had two crowns placed to restore the damaged teeth and went back to filming. The restoration was a good one, and all was well with his smile for the next few decades.
Until, that is, he began to notice a peculiar discoloration pattern. Years of coffee drinking had stained his other natural teeth, but not the two prosthetic (“false”) crowns in the middle of his smile. The two crowns, bright as ever, stuck out prominently from the rest of his teeth, giving him a distinctive look: “I looked like Bugs Bunny,” Mandel told Dear Doctor—Dentistry & Oral Health magazine.
His dentist, though, had a solution: dental veneers. These thin wafers of porcelain are bonded to the front of teeth to mask slight imperfections like chipping, gaps or discoloration. Veneers are popular way to get an updated and more attractive smile. Each veneer is custom-shaped and color-matched to the individual tooth so that it blends seamlessly with the rest of the teeth.
One caveat, though: most veneers can look bulky if placed directly on the teeth. To accommodate this, traditional veneers require that some of the enamel be removed from your tooth so that the veneer does not add bulk when it is placed over the front-facing side of your tooth. This permanently alters the tooth and requires it have a restoration from then on.
In many instances, however, a “minimal prep” or “no-prep” veneer may be possible, where, as the names suggest, very little or even none of the tooth's surface needs to be reduced before the veneer is placed. The type of veneer that is recommended for you will depend on the condition of your enamel and the particular flaw you wish to correct.
Many dental patients opt for veneers because they can be used in a variety of cosmetic situations, including upgrades to previous dental work as Howie Mandel experienced. So if slight imperfections are putting a damper on your smile, veneers could be the answer.
If you would like more information about veneers and other cosmetic dental enhancements, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers” and “Porcelain Dental Crowns.”
Today’s technologically advanced dentures aren’t your grandparents’ “false teeth.” Now made with superior materials and processes, you could almost forget you’re wearing them. But don’t let that cause you to leave them in for the night: While it may seem like a harmless thing to do, wearing dentures 24/7 may not be good for them or your health.
For one thing, around the clock denture wearing could worsen bone loss, already a concern with dentures and missing teeth. The forces generated when we chew on natural teeth stimulate new bone growth to replace older bone cells. When teeth go missing, though, so does this stimulus. Even the best dentures can’t restore this stimulation, so bone loss remains a risk.
And, dentures can accelerate bone loss because of the added pressure they bring to the bony gum ridges that support them. Wearing them all the time deprives the gums of any rest, further speeding up the pace of bone loss. Losing bone volume not only affects your overall oral health, it will gradually loosen your dentures’ fit and make them uncomfortable to wear.
Another problem: You may clean your dentures less frequently if you don’t take them out at night. Lack of cleaning can encourage bacterial growth and lead to disease. Studies show that people who don’t take their dentures out at night have more dental plaque accumulation, gum inflammation and higher blood counts of the protein interleukin 6, indicating the body is fighting infection.
And that’s not just a problem for your mouth. Continuous denture wearing could make you twice as likely to develop life-threatening pneumonia as someone who routinely takes their dentures out.
These and other concerns make nightly denture removal a good practice for your health’s sake. While they’re out, it’s also a good time to clean them: Manually brush them for best results (be sure you’re only using regular soap or denture cleanser—toothpaste is too abrasive for them). You can then store them in clean water or a solution designed for dentures.
Having said all that, though, there may be one reason why wearing dentures at night might be beneficial—it may help prevent obstructive sleep apnea. If you have this condition, talk to your dentist about whether wearing your dentures at night has more advantages than disadvantages. And, if bone loss created by wearing dentures is a concern, it could be resolved by having implants support your dentures. Again, discuss this with your dentist.
Taking care of your dentures will help increase their life and fit, and protect your health. And part of that may be taking them out to give your gums a rest while you’re resting.
If you would like more information on denture care, 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 “Sleeping in Dentures.”
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