Damaging the crown of a tooth (the part of the tooth that is visible above the gums) is the most common type of dental injury. The tooth may be broken or chipped. It is good to be prepared by knowing how such cases should be treated.

What is the first thing to do if my tooth is chipped or broken?
If fragments broke off the tooth, try to find and save them. They can probably be reattached to the tooth by bonding.

Does a chipped or broken tooth hurt?
The tooth may be sensitive to touch, hot and cold. Depending on the type of injury and how much of the tooth's inner surface is exposed, there may also be pain.

How long can I wait before getting treatment?
Get treatment right away, within 12 hours if possible. Teeth with crown fractures can be treated within 12 hours without affecting long-term outcomes.

What types of treatment may be used?
The treatment recommended depends on the tooth and the type and severity of the injury. Exposure of a tooth's inner pulp can be treated by a pulpotomy (partial pulp removal) technique. Front teeth can be temporarily restored with special cements, or the original tooth fragments may be reattached by bonding. Composite resin bonding may be used to restore the tooth's original appearance and function. Composites can be made in a wide range of tooth colors and can match the original tooth almost exactly.

Is treatment different if the damaged tooth is a primary (baby) tooth?
Chipped or broken primary teeth are generally treated similarly to permanent teeth. The treatment depends on the extent of the injury and damage to the tooth. Treatment of fractured primary teeth also depends on the proximity of the injured tooth to the permanent tooth beneath it, which will ultimately replace it. If a fractured primary tooth cannot be saved, it may be removed.

What if my tooth is loosened but not broken?
If the tooth is loosened but not cracked, broken or chipped, no dental treatment may be required. However, we will collect baseline clinical and x-ray information and keep an eye on the tooth or teeth in the future. We will need to check the tooth during recall visits to see whether the dental pulp is still living or whether it has died as a result of its injury. The latter condition can lead to a variety of problems and will require treatment.

Contact us today to schedule an appointment to discuss your questions about repairing a chipped tooth. You can also learn more by reading the Dear Doctor magazine article “The Field-Side Guide to Dental Injuries.”

Research has revealed that over 12 million Americans suffer from Obstructive Sleep Apnea (OSA), a condition that occurs when the upper airway (tissues at the back of the mouth and throat) collapse causing significant airflow disruption or even no airflow whatsoever for 10 seconds or more. It can leave you feeling tired, depressed, irritable, as well as cause memory loss and poor concentration. But, did you know that we can help treat your sleep apnea?

The primary method dentists who are trained in sleep medicine use to treat OSA is through the use of an oral appliance. Similar in look to an orthodontic retainer or sports mouthguard, oral appliances are designed to maintain an opened, unobstructed, upper airway during sleep. And while there are many different oral appliances available in the marketplace, less than 20 have been approved through the FDA (Food and Drug Administration) for treating sleep apnea. The key to success is to avoid those over-the-counter (OTC), generic mouthguards and instead use a professionally made and custom-fitted oral appliance, made from a precise models of your teeth and mouth. They are best at keeping your airway open and preventing the muscles and soft tissues from sagging down when relaxed during sleep. Other advantages of custom-fit oral appliances are that they can reposition your lower jaw, tongue, soft palate and uvula (the tissue in the back of the throat that dangles like a punching bag); stabilize your lower jaw and tongue; and increase the muscle tone of your tongue.

But Is Treatment Really That Important?

Absolutely! If undiagnosed and/or left untreated, sleep apnea can be life threatening. It can cause heart attacks, strokes, impotence, irregular heartbeat, high blood pressure, and heart disease — many of which can kill you.

Want To Learn More?

To learn more about sleep apnea, read the Dear Doctor article, “Snoring & Sleep Apnea.” Or if you are ready for a thorough examination and to discuss your snoring, contact us today to schedule an appointment.

For generations, root canal treatment has received a bad rap. Thought to cause pain, it is actually just the reverse. The truth is that root canal treatment does not cause pain but actually relieves it. Not only does root canal treatment relieve pain, it literally saves the affected tooth or teeth from further damage and/or loss.

To get started, let's define this procedure. A root canal treatment is a procedure in which the diseased pulpal tissue in the root canals are removed, disinfected, cleaned, and sealed. This is usually necessary following inflammation and infection of the pulp — which is the cause of your pain — as a result of severe decay or in a very heavily filled or damaged tooth.

However, if left untreated, an infected tooth can spread into the bone and even cause an abscess — and that can be more painful and impact your overall general health. The good news is that once a tooth has had the appropriate endodontic treatment (“endo” – inside; “dont” – tooth) followed by a proper restoration, it can last as long as your other teeth. The key is to take proper care of your teeth, have routine cleanings, and visit our offices as soon as you feel you have a problem with a tooth.

If you are having pain from a tooth or several teeth, you may need a root canal treatment. Please contact us today to schedule an appointment before it gets worse. To learn more about the signs, symptoms, and treatment for a root canal, read the article “Common Concerns About Root Canal Treatment.”

As America's toughest trainer on the hit television program The Biggest Loser, Jillian Michaels helped people learn that they hold the power to change. And if anyone knows about the power of changing oneself, it is Jillian Michaels. In her recent interview with Dear Doctor magazine, Jillian discusses her childhood, the trauma of being overweight as a teenager (5' 2" and 175 pounds), and the day her life forever changed when she started martial arts training at a gym. “I started training when I was 17 and always loved it but never thought it would end up being my career,” she said.

Jillian also reveals that when she was a child, she broke her two front teeth and had them repaired with crowns. She added, “Now, I generally wear a mouthguard if I am doing anything where my teeth have any chance of being knocked out.”

When it comes to replacing teeth that are broken or damaged from trauma, or teeth that are damaged because of dental decay, grinding habits, or acid erosion, crowns may be your best option. And because the tooth enamel is damaged, a bit more of it must be removed before we can place a crown. Generally speaking, we must remove about 2 millimeters of tooth structure to place a crown. Once the crown is placed, the tooth will always require a crown, as this is an irreversible procedure. However, the good news is that a crown not only mimics the look and feel of a natural tooth, but it is also the optimal long-term solution. On average, a crown last between 5 and 15 years and requires no special maintenance. In fact, you should treat your crown as you do your natural teeth, with a daily cleaning regimen of brushing and flossing and routine dental examinations and cleanings.

To learn more about crowns or other cosmetic procedures, contact us today to schedule an appointment so that we can conduct a thorough examination, discuss any questions you have as well as what treatment options will be best for you. Or to learn more about crowns now, you can continue reading the Dear Doctor magazine article “Porcelain Crowns & Veneers.” And to read the entire interview with Jillian Michaels, please see the article “Jillian Michaels.”

As a successful author, interior design guru (with 127 makeovers in eight years on The Oprah Winfrey Show), and host of his own television program, The Nate Berkus Show, Nate Berkus understands the important role a beautiful smile plays in one's life and career. In a recent interview with Dear Doctor magazine, Nate discussed his oral health history. Berkus credits his all natural smile — no cosmetic dentistry here — to the treatments he received as a child from his dentist. “I'm grateful for having been given fluoride treatments and sealants as a child.” He then added that, “healthy habits should start at a young age.”

Dental sealants are important because they help protect developing young teeth until the enamel has matured. Without dental sealants, the newly erupted immature enamel of teeth is more permeable, meaning that the acids produced by bacteria in the mouth can damage these teeth more easily. This makes the teeth less resistant and thus more susceptible to tooth decay.

Regardless of how much your children brush their teeth, the reality is that toothbrush bristles cannot reach down to clean out the crevices found in the deep grooves (“pits and fissures”) of teeth. And if not removed, the bacteria found in these grooves produce decay-causing acids as a byproduct of metabolizing sugar. However, when sealants are used in combination with fluoride, good hygiene and nutrition (including lower sugar consumption), the odds of having tooth decay is dramatically reduced.

We refer to dental sealants as “pit and fissure” sealants because they protect the grooves found in the top of back teeth and the back of front teeth. Sealants also may reduce the need for subsequent treatments as your child grows older — just as it did for Nate Berkus. For these reasons, sealants are definitely something that all parents and caregivers should consider for their young children.

To learn more about dental sealants, contact us today to schedule an appointment so that we can conduct a thorough examination, discuss any questions you have as well as what treatment options will be best for you or your child. Or to learn more about sealants now, you can continue reading the Dear Doctor magazine article “Sealants for Children.” And to read the entire interview with Nate Berkus, please see the Dear Doctor magazine article “Nate Berkus.”

Sucking their fingers or thumbs makes young babies feel secure and is completely normal behavior. Babies have been observed to suck their fingers or thumbs even before they are born. But like many comforting habits, over-doing pacifier, thumb, or finger sucking habits may be harmful.

Stop Pacifier Use by 18 Months

Studies have shown that pacifier use after the age of two may cause long-term changes in a child's mouth. We recommend that pacifier use should stop by about 18 months. A pacifier habit is often easier to break than finger or thumb sucking.

Stop Thumb and Finger Sucking by Age Three

Most children naturally stop thumb and finger sucking between two and four years of age, but some children continue this habit much longer. This may cause their upper front teeth to tip towards their lips or to come into position improperly. It can also cause their upper jaw to develop incorrectly. The American Academy of Pediatric Dentistry recommends that children stop these habits by age three.

Use of Behavior Management to Encourage Quitting

We offer creative strategies for gentle ways to cut back and stop pacifier use, including behavior management techniques that use appropriate rewards given at predetermined intervals. Meanwhile, make periodic appointments with us to carefully watch the way your child's teeth and jaws develop.

When your child is old enough to understand the possible results of a sucking habit, just talking about what may happen to teeth as a result can often encourage him/her to quit. As a last resort, a mouth appliance that blocks sucking may be needed.

If you are worried about your child sucking a pacifier, thumb, or fingers, please visit us to put your mind at rest. For more information read “Thumb Sucking in Children” in Dear Doctor magazine. Contact us today to schedule an appointment to discuss your questions about children's thumb sucking.

Everyone agrees that education is an important part of personal growth. However, one area of study that often slips through the cracks centers on oral healthcare basics. And whether or not we all do it as often as we should, most people know they should brush and floss their teeth daily. But other than that, do you feel you are knowledgeable and thus have a healthy dental IQ?

We have developed a quick and easy oral health IQ test to help you self-assess your expertise. The answers are listed at the bottom of this article.

The Quiz

1. What has been the largest, single factor influencing the decline in tooth decay over the past 40 years in America?
1. Fluoridated water
2. Fluoridated toothpaste
3. Flossing
4. Sealants
2. Your dentists can help treat which of the following problem(s)?
1. Halitosis (bad breath)
2. Snoring and sleep apnea
3. Headaches, Temporomandibular Disorder (TMD), or Temporomandibular Joint Dysfunction
4. All of the above
3. The most important aspect of brushing your teeth is...?
1. The brand of toothpaste you use
2. Your brushing technique and frequency
3. The brand of your toothbrush
4. Using an electric toothbrush
4. At a minimum, how often should you have a thorough dental evaluation?
1. Every six months
2. Once a year
3. Every five years
4. Only if you are experiencing pain
5. At a minimum, how often should you have your teeth professionally cleaned?
1. Every six months
2. Once a year
3. Every five years
4. It depends on your age and oral health

Want to learn more?

Contact us today to discuss your questions or to schedule a consultation. You can also learn more by reading the Dear Doctor article, “Oral Hygiene Behavior.”

The Answers

1) a = fluoridated water, 2) d = all of the above, 3) b = your brushing technique and frequency, 4) b = once a year, 5) d = It depends on your age and oral health