Posts for tag: dental injury
All eyes were on Boston Celtics point guard Isaiah Thomas in Game 1 of the second-round NBA Playoff series against the Washington Wizards — and not just because he scored a game-high of 33 points! Even more dramatic was the moment his jaw collided with an opponent’s elbow, sending one of his front teeth flying out of his mouth and onto the floor.
Press reports said the Celtics’ team physician attempted to reinsert the tooth, but it didn’t remain in place when Thomas resumed playing the game. Over the next several days, he reportedly underwent a total of ten hours of oral surgery, and was fitted with a four-piece temporary bridge. A statement from the team noted that Thomas suffered “a complete fractured tooth and two other subluxed/shifted teeth… [He] will receive a permanent bridge at a future date.” So what does all that mean?
When we say a tooth is fractured, it means the crown (visible part) of the tooth has broken off from its roots, either above or below the gum line. Depending on the severity of the fracture, it is sometimes possible to save the natural tooth by performing a root canal to prevent bacterial infection, and then placing a crown (cap) on the tooth to restore its appearance and function. In more severe cases, however, the tooth can’t be saved and must be extracted.
Unfortunately, that isn’t Thomas’ only problem. He also has two subluxed teeth — that is, teeth that have shifted from their original position, but haven’t been knocked out of their sockets. Subluxed teeth often result from a severe blow to the mouth, and may be treated by stabilization or splinting. Team officials haven’t said exactly what was done during Thomas’ dental treatment, but it could very well have involved extracting the roots of any teeth that couldn’t be saved, and possibly placing dental implants in his jaw for future tooth restoration.
A dental implant is a small screw-shaped titanium post that is inserted directly into the bone of the upper or lower jaw in a minor surgical procedure. In time, it becomes fused with the bone itself, offering a sturdy anchorage for replacement teeth. One implant can support one replacement crown; two or more implants can support a number of replacement teeth joined together as a unit. This is called a dental bridge.
Bridges can also be supported by adjacent healthy teeth — but first, the outer surfaces of the crown must be prepared (reduced in size), so that the bridge can be attached over the remaining part of the crown. In many instances, implants are preferred because they do not compromise the structure of healthy teeth nearby.
Dental difficulties didn’t end Isaiah Thomas’ season — but an earlier hip injury that became aggravated finally did.Â As unfortunate as this is, maybe now at least the NBA star will have a chance to let those injured teeth heal, and show up next season with a smile that’s as good as new.
Summer is a great time to go outdoors and get your game on—no matter whether your court is set up for tennis or basketball, whether you’re on the diamond or on the greens. Regular physical activity can help you maintain your optimal weight, reduce your risk for certain diseases, and even lower stress levels. But many of our favorite outdoor sports also carry a risk of accidental injury…and frequently this involves injuries to the mouth.
Because they’re front and center, the incisors (front teeth) are the ones most often affected by accidental injuries. While serious damage is relatively rare, chips and cracks are not uncommon. Fortunately, dentistry offers a number of good ways to restore chipped or broken teeth. Which one is best for you depends on exactly what’s wrong—but a procedure called cosmetic bonding is one of the most common ways to repair small to moderate chips where the tooth’s soft pulp isn’t exposed.
In dental bonding, a tooth-colored material is applied directly to the tooth’s surface to fill in the chip or crack. The material itself is a high-tech mixture of tough plastic resins, translucent glass-like fillers, and other substances. Strong, durable and lifelike in appearance, these composite resins can be matched to the natural shade of your teeth.
Bonding is a conservative procedure, meaning that it requires little or no preparation of the tooth. It can be done right in the dental office, often in a single visit and without the need for anesthesia. Unlike porcelain veneers or crowns (caps), it usually doesn’t involve removing significant amounts of healthy tooth structure.
While the results can last for years, bonded restorations aren’t as durable as porcelain veneers or crowns, which are made in a dental laboratory. Bonding also isn’t suitable to repair major damage, or in cases where the tooth’s pulp could become infected; in this situation, you may need a root canal and a crown. However, for moderate chips or cracks, bonding can be an appropriate and economical way to restore your teeth to full function and aesthetic appearance.
Of course, it’s often said that an ounce of prevention is worth a pound of cure. That’s why it’s best to wear a protective mouthguard whenever you’re on the field. We can provide a custom-made mouthguard that’s comfortable to wear and offers maximum protection against dental injury—just ask!
If you have questions about cosmetic bonding or mouthguards, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Artistic Repair of Front Teeth with Composite Resin” and “Athletic Mouthguards.”
A traditional root canal procedure can be a “life-saver” for a decayed or injured tooth. But while it’s usually the best course for a damaged adult tooth, variations of the procedure are advisable for a new permanent tooth in a child or young adolescent.
This is because the inner pulp, the focus of the treatment, plays an important role in a young tooth’s development. When it first erupts a tooth’s dentin layer, the living tissue that makes up most of the body and roots of the tooth, hasn’t fully formed. The pulp increases the dentin layer over time in conjunction with jaw development.
Because a full root canal treatment removes all of the pulp tissue, it could interrupt any remaining dentin development in a young tooth. This could lead to poorly-formed roots and a less healthy tooth. For an immature permanent tooth, then, we would use variations of a root canal treatment depending on the nature and extent of the injury, the patient’s overall health and medications they may be taking.
Our main objective is to expose or remove as little of the pulp tissue as possible when treating the tooth. If the pulp hasn’t been exposed by the decay or injury, we may only need to remove the softened decayed or injured dentin while leaving harder dentin nearer the pulp intact. If, however, the pulp has become partially exposed by disease or injury, we would then perform a pulpotomy in which we remove only the exposed tissue and then place calcium hydroxide or mineral trioxide aggregate (MTA) to stimulate dentin growth that will eventually patch the exposure site.
In cases where decay or injury has rendered an immature tooth’s pulp tissue unsalvageable, we may use a procedure known as apexification that seals off the open, cylindrical root end of the tooth. This will allow bone-like tissue to grow around the root to serve as added support for the tooth. Although it can save a tooth in the short run, the tooth’s long-term survival chances may be lower.
By using these and other techniques we may be able to save your child’s immature tooth. At the very least, such a technique could postpone replacing the tooth until a more opportune time in adulthood.
If you would like more information on treating damaged teeth in children, 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 “Saving New Permanent Teeth after Injury.”
Sports are an important element in human society — besides providing enjoyment they also build discipline, teamwork and character.
But sports activities, especially for children and teenagers, also carry the risk of physical injury — and your teeth and mouth aren’t immune. About 22,000 mouth injuries occur annually in individuals under the age of 18. As the degree of contact within the sport rises, so does the risk of dental injuries.
To reduce this risk, it’s important to adopt a comprehensive approach to dental injuries, beginning with protection. For any sport that involves a ball, stick, puck or physical contact with another player, athletes should incorporate two pieces of equipment to fully protect against mouth injury: headgear and a mouthguard. Both help to evenly distribute the forces generated during an impact and thus reduce the chance or severity of injury.
The design of headgear will depend on other factors involving a particular sport. Mouthguards are more singular in their purpose, and so what works in one sport should work in another. While there are a number of types like stock or “boil and bite,” the highest level of protection is a custom-fitted mouthguard created by a dentist to specifically fit the individual’s bite. Although more costly than other options, it can better reduce the chances of an even more costly mouth injury.
Because we can only reduce the risk of injury but never eliminate it, protection is only part of the approach. Individuals, parents and sports officials should have plans in place for treating dental injuries should they occur. Depending on the level of trauma, individuals should have access to a dentist as soon as possible. It’s also important to know what to do when specific injuries occur, whether they require an immediate, urgent or less urgent response. The Dear Doctor magazine article, “The Field Guide to Dental Injuries” is an excellent primer on dental injury treatment.
Sports can have a positive effect on physical, emotional and social development. Adopting a well-rounded approach to dental injury prevention and treatment will help keep the focus on those benefits.
If you would like more information on protection and treatment from sports-related 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 “An Introduction to Sports Injuries & Dentistry.”