Posts for: May, 2019
The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.
In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?
The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.
Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.
So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”
Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.
If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”
If you have a few missing teeth but can't afford dental implants or fixed bridgework, consider a removal partial denture (RPD). Although implants may be the superior choice aesthetically and functionally, an RPD can still effectively give you back your teeth.
RPDs are designed to replace one or more missing teeth but not a full arch like a full denture. Considered a permanent restoration, RPDs are also more durable than transitional "flippers," denture appliances that are flexible and light enough to be flipped out of the mouth with a flick of the tongue.
The key to both their affordability and durability is vitallium, a strong but lightweight metal alloy most often used in their frame construction. To it we attach artificial teeth usually made of porcelain or glass-filled resins that occupy the precise location of the missing teeth on the gum ridge. The artificial teeth and frame are surrounded by gum-colored plastic for a more natural look.
Each RPD is custom-made depending on the number and location of the missing teeth. Its construction will focus on minimizing any rocking movement of the RPD during chewing or biting. Too much of this movement could damage the adjacent teeth it's attaching to and cause the appliance to be uncomfortable to wear. We can stabilize the frame by precisely fitting it between teeth to buttress it. We also insert small rests or clasps made of vitallium at strategic points to grip teeth and minimize movement.
RPDs do have some downsides: their unique attachment with teeth encourages the accumulation of dental plaque, the thin bacterial film that's the leading cause of tooth decay and periodontal (gum) disease. These diseases can affect your remaining teeth's health and stability, which could in turn disrupt the fit of the RPD. Also, too much movement of the appliance can make the teeth to which it's attached become more mobile. It's important, then, if you wear a RPD to remove it daily for cleaning (and to thoroughly brush and floss your natural teeth), and to remove it at night to give the attaching teeth a rest.
A RPD can give you back the teeth you've lost for many years to come—if you take care of it. Maintaining both your RPD and the rest of your teeth and gums will help extend the life and use of this effective and affordable replacement restoration.
If you would like more information on teeth 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 “Removable Partial Dentures: Still a Viable Tooth-Replacement Alternative.”
X-ray imaging is such an intricate part of dentistry, we usually don't think twice about it. Without it, though, the fight against dental disease would be much harder.
At the same time, we can't forget that x-rays are a form of electromagnetic radiation that can penetrate human tissue. It's that very quality and the difference in the absorption rate between denser bone and teeth and softer diseased tissue that makes disease diagnosis possible.
But this same penetrative power can potentially harm the tissues it passes through. For that reason when practicing any form of x-ray diagnostics, dentists follow a principle known as ALARA, an acronym for "As Low As Reasonably Achievable." In lay terms ALARA means getting the most benefit from x-rays that we can with the lowest dose and exposure time possible.
While practicing ALARA with x-rays is important for patients of any age, it's especially so for children who are more sensitive to radiological energy given their smaller size and anatomy. We can't use the same settings, dosages or exposure times with them as with an adult.
To protect children, dentists have developed techniques and protocols that lessen their exposure time and rate, while still providing usable images for diagnosing disease. The bitewing is a good example of safe and effective pediatric x-ray imaging.
A bitewing is a plastic device holding exposable film that patients bite down on and hold in their mouth while x-raying. The x-rays pass through the teeth and gums and expose the film behind them on the bitewing. Using a bitewing we can capture a set of two to four radiographs to give us a comprehensive view of the back teeth, while exposing the child less radiation than they normally receive daily from background environmental sources.
This and other advances in equipment and digital imaging greatly reduce the amount of radiation patients receive during x-rays. If, though, you're still concerned about your child's x-ray exposure, talk with your dentist who can explain in more detail the x-ray safety protocols they follow. Just like you, they want your child to be as safe as possible while still benefiting from the diagnostic power of x-rays.
If you would like more information on safety precautions using x-rays with 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 “X-Ray Safety for Children.”