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.
If a breath of crisp winter air makes you say, “Ouch!” you're not alone. According to a study published in the Journal of the American Dental Association, one of every eight people suffers from tooth sensitivity. And for those individuals, winter can be a particularly challenging time of year.
Tooth sensitivity can result when the inner part of the tooth, called dentin, is exposed. Dentin is normally protected by enamel above the gum line and cementum below, but if the protective coating is lost, then temperature, pressure and acid from food and drinks can activate the nerves inside the tooth.
If you suffer from tooth sensitivity, these tips may help:
Avoid acidic foods and beverages. It may be common sense to stay away from foods and drinks that are hot or cold enough to make you wince, but also avoid those that are acidic, as acid can erode tooth enamel and increase tooth sensitivity.
Wait an hour to brush your teeth. After consuming acidic food or beverages, give your saliva time to neutralize the acid and strengthen the enamel surface to prevent erosion.
Brush gently. Gums can recede due to over-aggressive brushing, exposing sensitive tooth roots. So brush your teeth gently with a soft-bristled toothbrush and rinse with lukewarm water.
Use toothpaste for sensitive teeth. Toothpaste that is specially formulated for sensitive teeth blocks the pores in the tooth's surface where sensitivity can occur. It may also to help to rub the toothpaste on sensitive areas.
Sometimes, however, sensitive teeth result from dental problems that need professional treatment in the form of an at-home prescription, an in-office treatment like bonding or sealants, or a procedure like a gum graft or root canal. Accordingly, here's the most important tip of all:
Schedule a dental appointment. In an exam, we can look for the cause of your tooth sensitivity so it can be treated properly. Sensitivity may result from receding gums, tooth decay, erosion of the enamel, or other dental problems, such as the following:
- Tooth-grinding. If we detect signs of a nighttime tooth grinding habit that you may not even be aware of, we may recommend a nightguard to wear while sleeping.
- A root infection. If your tooth remains sensitive 30 seconds after eating or drinking something hot or cold, the pulp inside your tooth may be damaged. You may need root canal therapy to remove the infection and stop it from spreading.
- A cracked tooth. A crack in a tooth may not be visible due to its size or location, but a compromised tooth surface can cause sensitivity and could lead to bigger problems if not treated.
Don't let tooth sensitivity get you down this winter. Come see us so we can discuss the right treatment for you.
The timing around losing a tooth may not always sync with your financial ability. It's not unusual for people to postpone getting a dental implant—by far the best option for replacing a missing tooth—because of its expense.
So, if you have to postpone dental implants until you can afford them, what do you do in the meantime to keep your smile intact? One affordable option is a temporary restoration known as a flexible removable partial denture (RPD).
Composed of a kind of nylon developed in the 1950s, flexible RPDs are made by first heating the nylon and injecting its softened form into a custom mold. This creates a gum-colored denture base to which prosthetic (false) teeth are affixed at the exact locations for missing teeth.
Differing from a permanent RPD made with rigid acrylic plastic, a nylon-based RPD is flexible and lightweight, making them comfortable to wear. They're kept in place with small nylon extensions that fit into the natural concave spaces of teeth. And, with a bit of custom crafting, they can look quite realistic.
RPDs are helpful in another way, especially if you're waiting for an implant down the road: They help preserve the missing tooth space. Without a prosthetic tooth occupying that space, neighboring teeth can drift in. You might then need orthodontic treatment to move errant teeth to where they should be before obtaining a permanent restoration.
Flexible RPDs may not be as durable as acrylic RPDs, and can be difficult to repair or reline if needed to adjust the fit. Though they may not stain as readily as acrylic dentures, you'll still need to clean them regularly to help them keep looking their best. This also aids in protecting the rest of your mouth from dental disease by removing any buildup of harmful bacterial plaque on the RPD.
But even with these limitations, patients choose RPDs for the simple fact that they're affordable and temporary. And the latter is their greatest benefit—providing you a “bridge” between losing a tooth and replacing it with a durable dental implant.
If you would like more information on tooth replacement options, 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 “Flexible Partial Dentures.”
Although they can be expensive upfront, dental implants often prove to be a wise investment in the long-term. With a success rate that outperforms other teeth replacement restorations, dental implants could be the answer to a more attractive smile that could last for decades.
But while their success rate is high (95% still functioning after ten years), they can and do occasionally fail. Of those that do, two-thirds happen in patients who smoke.
This unfortunate situation stems from smoking's overall effect on dental health. The nicotine in tobacco constricts oral blood vessels, inhibiting the flow of nutrients and antibodies to the teeth and gums. Inhaled smoke can scald the inside skin of the mouth, thickening its surface layers and damaging salivary glands leading to dry mouth.
These and other effects increase the risk for tooth decay or gum disease, which in turn makes it more likely that a smoker will lose teeth than a non-smoker and require a restoration like dental implants. And blood flow restriction caused by nicotine in turn can complicate the implant process.
Long-term implant durability depends on bone growth around the imbedded implant in the ensuing weeks after implant surgery. Because of their affinity with the titanium used in implants, bone cells readily grow and adhere to the implant. This integration process anchors the implant securely in place. But because of restricted blood flow, the healing process involved in bone integration can be impaired in smokers. Less integration may result in less stability for the implant and its long-term durability.
To increase your chances of a successful implant installation, you should consider quitting smoking and other tobacco products altogether before implant surgery. If that's too difficult, then cease from smoking for at least one week before surgery and two weeks after to better your odds of implant success. And be as meticulous as possible with daily brushing and flossing, as well as regular dental visits, to reduce your risk of disease.
There are many good reasons to quit smoking. If nothing else, do it to improve your dental health.
If you would like more information on tobacco use and dental health, 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 “Dental Implants & Smoking.”
Knowing what to do—and what not to do—when your child is sick can greatly affect their health and well-being. That's especially true with dental problems.
Here then are some Dos and Don'ts for 3 common problems children experience with their teeth and gums.
Teething. An infant's first teeth breaking through the gums is a normal but often unpleasant experience. Fortunately, teething episodes only last a few days. And, there's usually no need to see the dentist unless they have a fever or diarrhea while teething. In the meantime:
- Do: provide them chilled (not frozen) cloth or plastic items to bite and gnaw, and massage their gums to relieve painful pressure. You can also give them an age-appropriate dose of a mild pain reliever.
- Don't: rub any medication on their gums, which can irritate them and other soft tissues. Never use alcohol or aspirin to alleviate teething discomfort. And avoid using anything with benzocaine, a numbing agent which can be hazardous to young children.
Toothache. Whether a momentary sensitivity to hot or cold or a sharp, throbbing pain, a child's toothache often signals tooth decay, a bacterial disease which could eventually lead to tooth loss.
- Do: make a dental appointment at your child's first complaint of a toothache. Ease the pain with a warm-water rinse, a cold compress to the outside of the jaw, or a mild pain reliever.
- Don't: rub medication on the teeth or gums (for similar reasons as with teething). Don't apply ice or heat directly to the affected tooth or gums, which can burn them.
Bleeding gums. Gum bleeding from normal brushing or flossing, along with red or swollen gums, may indicate periodontal (gum) disease. Although rare in children, it can still happen—and it can put an affected tooth in danger.
- Do: see your dentist if bleeding continues for a few days. Continue to brush gently with a soft-bristled toothbrush around the gums to remove plaque, a thin-biofilm most responsible for gum infection.
- Don't: brush aggressively or more than twice a day, which could unnecessarily irritate and damage the gums. And don't stop brushing—it's important to remove plaque buildup daily to lessen the gum infection.
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