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Author: Service Lifter

Root Canal Retreatment

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Most of the time, root canal therapy is effective at permanently relieving tooth pain and halting infection of the soft tissues deep inside the teeth and gums. But occasionally, as in any medical procedure, the body may not heal as we expect it to. After a period of time, you may experience pain in the affected tooth again — or, even if you have no symptoms, x-rays may reveal that infection is still present near the tooth’s roots. In that case, you may need root canal retreatment.

There are several reasons why your root canal treatment may not have succeeded at first. The “canals” themselves are slender, forking passageways deep inside the tooth that enclose nerves and blood vessels: the tooth’s soft “pulp.” They can be so narrow and intricate that some may have gone undetected, or failed to respond to treatment the first time. Or, the canals might have become recontaminated via a number of routes: a delayed or ineffective crown restoration, new tooth decay, advancing gum disease, or a cracked or fractured tooth. Any of these conditions could result in reinfection.

If initial root canal (endodontic) therapy has failed, the first thing to do is evaluate your options. Besides retreatment, the alternatives may include endodontic surgery or extraction (removal) of the tooth. However, a missing tooth should be replaced by a dental implant, a bridge or a partial denture as soon as possible — and none of these are simple or inexpensive options. That’s part of the reason we prefer to help you retain your natural teeth whenever possible.

The Retreatment Procedure

If endodontic retreatment is appropriate for you, the procedure is similar to a routine root canal, with a few added measures. After you are anesthetized (usually with a numbing shot), any restorations presently on your tooth — crowns, for example — will be altered to provide access to the root canal filling material. This is usually accomplished by making a small opening into the inner part of the tooth, removing filling material or obstructions, and cleaning the pulp chambers with tiny instruments.

A microscope and light are used to search carefully for additional canals or unusual structures. If the treatment process becomes extremely complex, it may be finished in a subsequent visit. Finally, when all the canals have been cleaned and disinfected, they will be filled with inert material and sealed. Then a temporary filling will be placed in the tooth. A permanent restoration will need to be placed at a later time.

Is Root Canal Retreatment My Best Option?

Medicine and dentistry are as much art as science, and neither one can guarantee that any procedure will be 100% successful. While endodontic retreatment can be more complex than initial root canal therapy, it offers a good chance of success in many instances. And, since the field of endodontics is constantly evolving, it may be possible to use new techniques that weren’t available when your first root canal procedure was done.

Dentists take seriously our responsibility to help you understand the risks, benefits and alternatives for treating root canal problems. When we recommend retreatment, it’s because we feel it is the best way for you to preserve your natural teeth — and we want you to be able to enjoy them for many years to come.

Nutrition & Oral Health

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You probably already realize that maintaining a balanced diet offers a host of benefits to your overall health. But did you know diet also directly affects the health of your teeth and gums? It all starts before birth, as a baby’s teeth begin forming in the sixth week of pregnancy and mineralizing in the third or fourth month. During this time, an expectant mother needs to take in lots of calcium (the major component of teeth) along with vitamin D, phosphorous and protein. Dairy products including milk, cheese, and yogurt have all of these. Broccoli and kale also have calcium, while meats are good sources of protein and phosphorous. These foods are also important for children, whose teeth continue to develop and mineralize through the teen years.

Throughout life, oral tissues are constantly recycling; they need a variety of nutrients to support this process. It’s equally important to recognize that nutritional deficiencies — a particular concern among older adults who have lost teeth — can reduce resistance to disease and hinder your ability to fight infection. Studies have consistently found that a high intake of fruits and vegetables reduces the risk for oral cancer — as well as other types of cancer. That’s why eating a nutritious diet is important for oral health — as well as general health — at any age.

Eating Healthy

What’s the best diet for you? That depends mainly on your age, gender, height, weight and level of physical activity. But in general, a health-promoting diet is based on the concepts of:

  • Variety. No single food can meet all of the daily nutrient requirements. Eating lots of different foods also makes meals more interesting.
  • Balance. We need to eat the recommended amounts of foods from specific categories on a daily basis. Find out what your specific needs are at www.choosemyplate.gov
  • Moderation. Don’t supersize it. Foods and beverages should be consumed in serving sizes that are appropriate to meet energy needs while controlling calories, fat, cholesterol, sodium, and — particularly important in the dental arena — sugar.

Protecting Your Teeth

Your diet (which includes what you drink) plays a major role in tooth decay and enamel erosion. Your mouth is naturally hospitable to all kinds of bacteria. Some of these microorganisms are helpful and some are harmful, and many of the harmful ones thrive on a steady supply of sugar. As they process sugar from your diet, these bacteria produce acids that can eat into the enamel of your teeth, forming small holes called cavities. If left untreated, tooth decay can worsen, become quite painful, and threaten the survival of teeth.

That’s why it is important to avoid food and drinks with added sugar. If you have a sugar craving (and we all do from time to time), choose fresh fruit or yogurt instead of a donut or candy bar. Fortunately, there is no evidence that sugars in whole grain foods, whole fruits and vegetables, and in starch-rich staple foods like bread, rice and potatoes are harmful to teeth.

Soft drinks, however, are a double whammy for teeth; many not only contain lots of sugar — up to 10 teaspoons per 12-ounce can — but they are also highly acidic. This means they erode teeth on contact, even before the bacteria in your mouth have processed the sugar these drinks contain. But even if they are sugar-free, the acid can still harm your teeth. So it might be best to avoid soda, sports drinks, energy drinks and canned iced tea. If you do occasionally have a soda, swish some water in your mouth afterwards — but don’t brush your teeth for at least an hour! Doing so could make it easy for tooth enamel, already softened up by acid, to be eroded away by brushing.

Drinking lots of water can help you maintain a healthy supply of saliva, which protects teeth by neutralizing acid. You can also neutralize the acid in your mouth after a sugary snack by following it up with a piece of cheese.

Finally, remember that it’s not just what you eat that affects the level of acidity in your mouth — it’s also when. Snacking throughout the day, especially on chips, crackers, cookies or candy, means that your saliva never gets the chance to neutralize the harmful acids being produced. So if you eat sweets, do it only at mealtimes. As an added incentive, you may find this helps you maintain a healthy weight, too!

Diabetes & Oral Health

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Diabetes is a group of chronic inflammatory diseases that affect the body’s ability to process sugar. If you have diabetes, it is particularly important to maintain excellent oral health. That’s because diabetics are more prone to oral infections such as periodontal (gum) disease, which can result in tooth loss if left untreated. Conversely, the presence of gum disease can make it harder for people with diabetes to control their blood sugar levels.

Periodontal disease is a chronic ailment that is also associated with an elevated level of systemic (whole-body) inflammation. Like diabetes, it may have wide-ranging consequences outside the mouth — possibly increasing a person’s chance of experiencing major cardiovascular events (such as heart attack or stroke) or adverse pregnancy outcomes (low birth weight and pre-term delivery). So perhaps it’s not surprising that a growing body of evidence suggests the two diseases are related.

Two Diseases With A Lot In Common

It has long been recognized that having diabetes is a risk factor likely to increase the severity of periodontal disease. That’s because diabetes reduces the body’s resistance to infection, making diabetics more susceptible to both bacterial and fungal infections. Likewise, evidence shows that having serious gum disease (periodontitis) is likely to result in worsening blood glucose control in diabetics; it can also increase the risk of diabetic complications. So, what’s the connection?

While no one is sure at present, the two diseases seem to share some common pathways and disease-causing mechanisms. Both are associated with the process of inflammation and the immune response. Inflammation itself — often signaled by pain, heat and redness — is evidence of the body’s immune system at work, attempting to fight disease, repair its effects, and prevent it from spreading. Chronic or prolonged inflammation, however, can lead to serious problems in different parts of the body and a decline in overall health.

What does this mean to you? According to one large study, if you’re diabetic, your risk of dying from heart attack is over twice as great if you also have severe periodontitis — and for kidney disease, your risk is 8.5 times higher! Plus, uncontrolled periodontal disease makes it six times more likely that your ability to control blood sugar levels will get worse over time. So not only can having one condition put you at risk for worsening the other — having both can cause a significant deterioration in your overall health.

A Two-Way Street

While diabetes can’t be cured, it’s possible to manage the disease on a long-term basis. And here’s some good news: Clinical studies show that diabetics who get effective treatment for their periodontal disease also receive some significant benefits in their general health. Many exhibit better blood glucose control and improved metabolic functioning after periodontal treatment.

What kinds of treatments might be needed? While much depends on the individual situation, some typical procedures might include: scaling and root planing (a deep cleaning that removes plaque bacteria from teeth, both above and below the gum line); antibiotic therapy; and oral hygiene self-care instruction.

Likewise, if you’re at risk for diabetes but haven’t yet developed the disease, there are some things you can do to forestall it. While there is a significant genetic component, a major risk factor for diabetes is being overweight — so keeping your weight under control will better your chances of avoiding it. High levels of triglycerides or low levels of HDL (good) cholesterol are also risk factors. These may respond to changes in your diet — like cutting out sugary drinks and eating healthier foods. Also, high blood pressure coupled with an inactive lifestyle puts you at greater risk. Here, moderate exercise can help.

When you come to our office, be sure to let us know if you’re being treated for, or are at risk of developing diabetes. And if you are managing the disease, remember that it’s more important than ever to maintain good oral health.

Facial Trauma And Reconstructive Surgery

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When you were a youngster, did you ever get a black eye, chip a tooth or bruise your cheek? If so, you may have experienced a case (let’s hope, a mild one!) of facial trauma. In many situations, however, facial trauma can be severe. Among its major causes are auto accidents, sports injuries, work-related mishaps, falls, and acts of violence. When serious facial injury occurs, it’s important that you receive immediate and comprehensive care. That’s why oral and maxillofacial surgeons are on call at most emergency and trauma centers.

Facial trauma in general involves injuries to the soft- or hard-tissue structures of the face, mouth or jaws — including the teeth, the bones of the jaws and face, and the tissue of the skin and gums. It can also involve treatment of particular specialized regions, such as the area around the eyes, the salivary glands or facial nerves. Because facial injuries can affect not only a person’s ability to carry on basic life functions (eating, vision, etc) but also his or her appearance, there is often a strong emotional component to treatment as well as a physical one. But after completing an extensive training program, oral and maxillofacial surgeons are capable of handling the full scope of facial injuries.

Treatments for Facial Injury

Some facial traumas are relatively minor. A common one occurs when a tooth is loosened or knocked out (avulsed). Many times, if treated immediately, the tooth can be successfully re-implanted in the jaw. If that isn’t possible, placing a dental implant is often the most effective way to replace a missing tooth.

Another type of relatively common but more serious injury may involve a fracture of the facial bones, including the cheekbones, upper or lower jawbones, or the eye sockets. In principle, its treatment is essentially the same as that used for a broken arm: place the bones back in their proper position, and immobilize them. But since it isn’t possible to put a cast on the face, different immobilization techniques are used. One method involves wiring the upper and lower jaws together to let them heal in the correct alignment; alternatively, plates and screws may be used to permanently reattach the bones.

Severe facial trauma is often a critical condition, since over 60% of these patients also have serious injuries in other parts of the body. In fact, many of the standard techniques used in trauma centers were developed by oral and maxillofacial surgeons during the wars in Korea, Vietnam, and the Middle East. Restoring breathing, controlling bleeding and checking for neurological damage are top priorities. After that, as much of the reconstructive surgery as possible is accomplished in one operation.

Preventing Facial Trauma

What’s the best treatment for facial trauma? Prevention. Always wearing seat belts, using proper helmets and protective gear when playing sports, and staying out of dangerous situations (like driving while impaired, tired or distracted) can go a long way toward keeping you safe. If you’re engaging in athletic activities that carry any risk of facial injury, wear a properly fitted mouthguard — this small piece of protective equipment can save you a lot of potential harm.

But if you (or someone you care for) require a trip to the emergency room for a facial injury, be sure to ask for a consultation with an oral and maxillofacial surgeon, so that you get the best care and the most favorable outcome.

Thumb Sucking

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Sucking on a thumb or finger is a completely normal habit that some babies develop even before they’re born. It’s soothing, and it also helps babies make contact with and explore their environment. If sucking habits go on much past the age of 3, however, it’s possible that bite problems may arise.

In a normal bite, the upper teeth grow to overlap the lower teeth. But it’s possible for the pressure of a thumb, finger or pacifier resting on the gums to interfere with normal tooth eruption and even jaw growth. Some thumb-suckers develop an “open bite,” meaning the teeth don’t overlap when a child bites together (View Example); instead, there is an open space between the upper and lower teeth. That’s why thumb sucking is definitely something we should keep an eye on, though we don’t want to intervene too soon.

Breaking the Habit

It’s important to keep in mind that most children break thumb-sucking habits on their own between the ages of 2 and 4. So if you’re trying to get your child to stop, the first thing to do is simply ignore it. Pacifiers will usually be given up more quickly than thumbs or fingers. If your child seems unable to stop when it’s time, positive reinforcements tend to work better than negative (e.g., putting a bitter substance on the thumb). Here are some things you can try:

  • Praise & Reward. Explain to your child why it’s so important not to suck thumbs and think of a way to reward her for not doing it — as long as it’s not with tooth-harming sweets! Stickers or an activity they enjoy might serve well. Always offer gentle reminders rather than scold when you notice a thumb in your child’s mouth, and praise her when she stops.
  • Comfort & Distract. Children have different triggers for thumb sucking. Does your child tend to do it when stressed or bored? If so, some extra hugs might help, or an activity to keep those little hands busy.
  • Get Creative. You know your child best. Maybe there’s a method that would be particularly motivating to him. For example, you could tie his pacifier to a helium balloon and send it up to the Tooth Fairy. When she receives it, she can leave a special present under his pillow!
  • Get Help. If your child sucks her thumb, fingers, or a pacifier, dentistry can help. Sometimes a brief conversation with a caring dental professional is all that’s needed to help her understand how it will help her teeth to kick the habit. If necessary, she can be fitted with a special oral appliance called a tongue crib (View Example), which physically prevents thumb sucking and can usually break the habit in a few months.

Thumb sucking is just one reason why it’s important to maintain your child’s regular schedule of dental exams, starting at age 1. At these appointments, you and your child can also learn effective oral hygiene techniques to help prevent tooth decay. Meanwhile, your child’s dental growth and development will be monitored. Though orthodontics can usually fix bite problems that result from sucking habits, we’d just as soon help you avoid this expense if possible!

Sleep Apnea & Behavior Problems In Children

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The number of children diagnosed with Attention Deficit Hyperactivity Disorder (ADHD) has been steadily increasing over the past decade. Yet according to a recent study, many children diagnosed with this condition don’t really have it; their behavioral problems are actually related to sleep-related breathing disorders (SRBD), such as sleep apnea.

The 2012 study, published in the journal Pediatrics, followed more than 11,000 children for six years, starting when they were 6 months old. The children who had SRBD were 40 percent to 100 percent more likely than kids without breathing issues to develop behavioral problems resembling ADHD by the age of 7. So if your child is exhibiting ADHD-like symptoms — or has even been diagnosed with ADHD — it’s worth considering whether interrupted sleep might be an issue.

It makes perfect sense when you think about it: A well-rested individual, young or old, can function a lot better on a good night’s sleep. Yet a lack of sleep affects adults and children differently. While sleepy adults tend to act sluggish and drowsy, sleep-deprived kids are more likely to become hyperactive, uncooperative and unable to focus — just like kids with ADHD.

So What Exactly Is SRBD?

The condition is characterized by recurrent episodes of interrupted breathing during sleep. The child’s airway becomes blocked by soft tissues near the back of the throat — tonsils or the tongue, for example — that partially close off the windpipe. These tissues can vibrate as air passes by, causing snoring. It’s often worse while sleeping on one’s back because this encourages the lower jaw to slip back, which in turn pushes the tongue in front of the airway.

Overweight children have a higher incidence of sleep apnea due to fatty tissue deposits in the soft palate, which decrease the size of the child’s airway.

Does your child have a sleep-related breathing disorder? You can gather clues to report to your health professional by observing your child sleeping. Look for the following signs:

  • Snoring
  • Pauses in breathing
  • Chronic mouth breathing
  • Constant tossing and turning
  • Night panics
  • Bed-wetting

How Is Sleep Apnea Treated In Children?

There are various treatments that can be very effective, depending on the cause. Enlarged tonsils and adenoids can be surgically removed. A therapy known as Continuous Positive Airway Pressure (CPAP) involves the use of a machine that delivers mild air pressure through a mask worn during sleep to keep the airway open.

How palatal expanders work.
Dentistry also can also play a role in treatment. For younger children who are still growing, the use of an orthodontic appliance called a palatal expander has proven helpful in some cases. A palatal expander gently widens the roof of the mouth (palate) over time by separating bones that don’t permanently fuse together until puberty. It’s most often used to create more room for crowded teeth, but the expansion can also increase airflow.

Older children who have stopped growing can sometimes benefit from Oral Appliance Therapy (OAT). This involves wearing a custom-made oral appliance designed to reposition the jaw during sleep so that the tongue is held away from the back of the throat, reducing the potential for obstruction.

The first step is to figure out what’s keeping your child from getting the restful sleep that’s so crucial to good health and well-being. For that to occur, and for your child to receive the best treatment, you will need to see a trained professional.

Tooth Wear

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With proper care, your teeth can last a lifetime. But some amount of wear as we age is normal. By “wear,” we mean loss of tooth structure. Wear starts with loss of the hard, translucent enamel that forms the outer covering of teeth, and might, in more serious cases, progress to the softer inner tooth structure known as dentin.

Enamel is actually the human body’s hardest substance. It is highly mineralized and non-living, in contrast to bone and dentin which are living tissues. Enamel is highly resistant to wear and chemical attack, as it would have to be given what your teeth do every day: bite, chew, and come in contact with acidic foods and drinks.

Still, it is possible for tooth enamel to wear down for various reasons. Your body has ways of compensating for minor wear. But when tooth wear becomes more significant, intervention may be necessary to keep your bite functioning properly and protect your teeth.

Types of Tooth Wear

Tooth wear can result from one or more of these processes:

Abrasion: This is caused by the interaction of teeth and other materials rubbing or scraping against them. The most common source of abrasion is traumatic toothbrushing, meaning that you are using a toothbrush that’s too hard or applying too much force when you brush. This can affect the root surfaces of your teeth just below the gum line or the enamel above the gum line. Other causes of abrasion can include improper use of toothpicks and dental floss. Some dental appliances such as partial dentures or retainers that are frequently taken in and out of the mouth can also abrade teeth. Abrasion can also result from a diet loaded with abrasive foods like sun flower seeds and nuts or habits such as nail-biting and pen-chewing.

Attrition: This is an effect of tooth-to-tooth contact, which happens many times throughout the day as your teeth bite and chew food. Biting and chewing normally generate forces between 13 – 23 pounds. Yet people who have clenching and grinding habits (of which they might not even be aware) can subject their teeth to forces up to 10 times that. This can damage teeth.

Erosion: When your teeth come in contact with acidic substances in your diet, the acid can actually erode (dissolve) the enamel on your teeth. Culprits of this kind of tooth wear often include sodas, sports drinks and so-called energy drinks. Certain fruit juices are also acidic. Confining these drinks to mealtimes and swishing water in your mouth after drinking them can help prevent this erosion.

Abfraction: This refers specifically to the loss of tooth enamel at the necks of the teeth (the thinner part right at the gum line). While this type of wear is not clearly understood and the cause is debated in dentistry, loss of tooth structure at the neck of teeth does happen. It is believed to be caused by tooth flexion from biting forces. Abrasion and erosion can contribute to this problem.

Treating Worn Teeth

In order to treat your worn teeth, the cause of the wear must be determined during a simple oral examination at the dental office. Once the cause has been identified, the stresses on your teeth can be reduced if need be. For example, you may need instruction on gentle, effective tooth brushing techniques; or some changes to your diet. If you have a clenching or grinding habit, a mouthguard can be custom-made for you that will protect your teeth during sleep or periods of high stress.

Lost tooth structure sometimes needs to be replaced so your bite functions properly and your teeth look great once again. Depending on the situation, this can be done with bonding, veneers, or crowns. Fortunately, modern dentistry can restore the normal shape, appearance and function of worn teeth — beautifully and successfully!

Laser Decay Diagnosis

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Laser technology is becoming quite commonplace in a wide variety of areas throughout the healthcare industry; but did you know that it can now be used to detect tooth decay? Today, using a small, handheld device, it is possible to detect tooth decay that is not yet visible and would otherwise be undiagnosed by conventional methods alone.

Plus, traditional methods of detecting tooth decay are much more accurate and efficient when laser technology is included by your dentist. You can expect:

  • dramatically improved early cavity detection
  • reduced size and possibly number of fillings that might be needed, thus possibly lowering the cost of dental treatments
  • reduced chances of unnecessary exploration of teeth that are suspected to have cavities

Here’s how it works

Using this noninvasive technology, your teeth are scanned to examine their structure. Laser cavity detection is based on the fact that healthy tooth structure reflects light, or “fluoresces,” differently than does decayed tooth structure. Healthy teeth will have little-to-no fluorescence while teeth with decay display with a higher level of fluorescence. And the higher the fluorescence, the more advanced the tooth decay. Once the scan is complete, the fluorescence readings are converted into a digital numeric output. You will also “hear” when you have decay present, as changes in fluorescence and numeric value are emitted as an audio signal that goes up in tone as it denotes the presence of decay.

Why is this so important?

Tooth decay may be more difficult to detect today than it was in the past. Why? It’s probably due in part to improved oral hygiene, and, ironically, the increased use of fluoride in toothpaste and in tap water. While fluoride has proven invaluable at protecting teeth by hardening their outer enamel surface, that increased hardness can sometimes conceal even aggressive decay. As a result, tooth decay can be difficult to find, even with the use of traditional x-rays.

Furthermore, prior to using a laser scanner, dentists depended upon x-rays and using fine picks to identify cavities. However, using laser technology provides about a 90% accuracy rate for identifying suspicious areas and cavities. This translates to earlier detection, less tooth structure loss resulting in stronger teeth, less time spent in the dental chair, and, ultimately, a financial savings to you.

Hidden Consequences Of Losing Teeth

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If you have lost any of your teeth, you no doubt realize there are consequences to living without them: Your smile may not look the way you want it to; eating, speaking and intimacy may be more difficult; and your self-confidence may fade. Though serious, these are not the only impacts. There are hidden consequences of losing teeth that affect not only your appearance but also your health.

Importantly, a loss of jawbone inevitably follows tooth loss. Bone needs stimulation to maintain its form and density. In the case of the jawbone, that stimulation comes from the teeth, which make hundreds of fleeting contacts with each other throughout the day. The small stresses produced by these contacts are transmitted to the bone, prompting it to regenerate constantly. When a tooth is lost, the stimulation it provided disappears. In just the first year of tooth loss, there is a 25% decrease in bone width. This is followed over the next few years by an overall 4 millimeters decrease in height. If enough teeth are lost, and as bone loss continues, the distance from nose to chin can decrease and the lower third of the face partially collapses. With a lack of structural support, the lips sag; that’s why toothless people often appear unhappy. Also, extreme loss of bone can make an individual more prone to jaw fractures.

You may also find that some of your remaining teeth actually shift into the spaces left open by your missing teeth. This in turn can cause additional bite problems and even jaw joint (TMJ) pain. Finally, compromised nutrition and poor general health can result if eating healthy foods like raw fruits and vegetables becomes too difficult without teeth.

Now here’s the good news: Dental implants — the state-of-the-art tooth-replacement method preferred by dentists — can prevent all this.

How Dental Implants Prevent Bone Loss

Dental Implants 101.Besides helping a person without teeth look and feel great again, dental implants actually prevent bone loss. That’s because they are made of titanium, which has a unique ability to fuse to living bone. By actually becoming a permanent part of the jawbone, dental implants stabilize and stimulate the bone to maintain its volume and density.

Dental implants are placed during a minor surgical procedure using local anesthetic and then, after a healing period, topped with a lifelike dental crown. Together, these precision components look, feel and function exactly like your natural teeth. Dental implant success rates exceed 95% — the highest of any tooth-replacement option.

Other Options for Tooth Replacement

Other than dental implants, your tooth-replacement options include fixed bridgework that incorporates or uses the adjacent teeth, and removable dentures. You should be aware, however, that the disadvantage of both of these options is that they may damage the anatomical structures on which they rest. For example, fixed bridges rely on support from two adjacent, possibly healthy teeth, which must be filed down and capped; this can make them susceptible to decay and root canal problems. Removable partial dentures hook onto existing teeth, which may become loose over time. And full dentures press on the bony ridges that used to support the teeth, accelerating the bone loss that began when the teeth were lost in the first place.

The above tooth-replacement options are all less expensive than dental implants, but only when viewed in the short term. Since bridgework and dentures may cause new problems and will likely need replacement themselves, they don’t offer the same long-term value. When viewed as an enduring investment in your comfort, health and well-being, implants offer the best return by far.

Orthodontic Emergencies

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At first, having orthodontic treatment may take a little getting used to. It isn’t uncommon to experience a bit of soreness when appliances are first put on, or some minor aches as teeth begin moving into new positions. Yet it’s comforting to know that genuine orthodontic emergencies are rare.

If you think you may have an emergency, however, the first step is to determine the severity of the problem: Is it an urgent situation that requires immediate attention, or a minor problem that you can take care of yourself, temporarily, until you can come in to the office?

A Major Emergency

There are only a few true orthodontic (or dental) emergencies. They include:

  • Trauma or injury to the teeth, face or mouth
  • Infection or swelling of the gums, mouth or face
  • Severe, unmanageable discomfort or pain in these areas

In any of these situations, you should seek help as soon as possible — go to an emergency room, if that’s your best option. Generally, however, the place to start is at the dental office. If, for example, you have a fractured tooth, that immediate problem requires diagnosis and treatment. Afterwards your orthodontic treatment plan can be adjusted as needed. Likewise, severe pain or swelling could be a sign of infection or disease, which also needs immediate treatment.

Some Minor Troubles

Fortunately, the vast majority of orthodontic problems are minor compared to these situations — but they may still cause discomfort or irritation. In general, it’s best to try and soothe the immediate cause of the discomfort, and then call for an appointment. Here are a few of the more common orthodontic problems, along with some tips on what you can do to relieve them at home:

Loose or broken brackets, bands or wires

This problem is often caused by eating hard or sticky candy or food, or playing with the braces. If the band or bracket is still attached to the wire, leave it as is — but don’t connect any elastics to it! You can cover it with orthodontic wax if it’s irritating the inside of your mouth. If it has come off, save it. In either case, call our office to let us know what happened, and we will recommend the next step.

Misplaced or poking archwire, bracket or tie

As the teeth start to move, the wire that connects them (archwire) may begin poking near the back of the mouth or irritating the cheeks. You can try moving the wire into a better position with a pencil eraser or a Q-Tip. If the wire won’t move, you may be able to cut the end off with a nail clipper sterilized in alcohol — but before doing so, please call for guidance or instructions. Often, you can also use tweezers to gently move a misplaced wire or a tie that’s causing problems.

When wires or brackets cause irritation, covering the metal parts with wax will often help ease the discomfort. As with any of these types of problems, it’s best to make an appointment so it can be taken care of.

General tooth pain or loosening

It’s normal for teeth to become slightly loosened during orthodontic treatment — that shows they’re moving! Sometimes, this movement may be accompanied by tenderness, especially after braces are placed or adjusted. For minor soreness, you can use your regular over-the-counter pain reliever. A twice-a-day salt-water rinse may also help: Mix one teaspoon of salt in an 8-ounce glass of warm water, and rinse for 30 seconds. A warm washcloth or heating pad placed on the outside of the jaw can also offer some relief.

While actual emergencies are rare, the goal is to make orthodontic treatment as comfortable as possible.