I cracked my tooth, do I need a crown?

Okay so you, your child, your mom, your brother, etc. etc. just fell face first into something, over something, under something, etc. etc. and broke the corner of your/their front tooth off.

What do you do now?

Well, that depends. Lets break this down into 3 simplified categories.

The nerve of a tooth is in the middle of the tooth.

#1 If you just broke off a small corner of the tooth and it didn't reach the nerve then a simple filling is probably all you would need.

#2 If you broke off a larger corner but still didn't reach the nerve then you more then likely would need a crown.

#3 If you broke your tooth so severely that you got down into the nerve then you will need a root canal AND a crown.

And although all of this may be a traumatic experience don't worry. Your cracked and broken smile can be completely repaired and have you back to being the model you know you were born to be.

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Thumb Sucking

Is allowing your child to suck their thumb a bad thing?

Yesterday I talked about letting your child suck on a pacifier and basically said that I had no problem with that.

I feel, that letting your child suck on their thumb is something completely different.

The biggest reason for this is the pressure that can be applied by the child's finger to the teeth and roof of the mouth.

A pacifier is passive. No force is applied by it. On the other hand, a child can use their thumb to apply a tremendous amount of force.

This force can have multiple side effects.

One of those side effects is that the upper front teeth are actually forced upward and outward.

With the teeth in this position it would become impossible for those teeth to function as they were designed to. The front teeth are meant to cut pieces of food into smaller pieces before they are moved to the back teeth for grinding it down before swallowing. If the upper front teeth do not touch the lower front teeth then it would be very difficult to cut through anything.

the next problem with teeth that do not touch would be that a child's speech patterns would be changed. During the formation of certain sounds the tongue needs to rest against the upper front teeth. If the upper front teeth are not in the proper position then the sounds made by the child will not come out as they should.

So what can be done to stop a child from thumb sucking?

There are lots and lots of ideas out there.

Some people choose the simple idea of painting hot sauce on their child's finger. Hopefully they still love you after that.

The next idea is to place an appliance in the child's mouth like the one below. The balls the sit on the wire prevent the child from getting any suction thus the child gets less satisfaction and gives up.

You can also go the route of putting something on your child's hand. The device below also prevents the child from completely sucking on their thumb.

Point is that you need to get your child to stop sucking on their thumb.

Any of these ideas would work.

The only thing I do not recommend is yelling at your kids. That never really helps anything.

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Are pacifiers bad?

Well, like most things, the answer is ............ it depends.

Sucking is a very natural and calming thing for a baby to do.

I have given each and every one of my 5 kids a pacifier.

None of them are delayed in their teeth coming in, have any speech problems, or had any thumb sucking problems due to using a pacifier.

There are some obvious thing you should be concerned with.

If you use a clip and a cord to keep the pacifier attached to your child's clothes make sure the cord is short enough that can't choke the baby.

Once your child gets to kindergarten make sure that they only use the pacifier at home. Being known as the only kid that had a pacifier in kindergarten could seriously damage your child's chances at getting asked to junior prom.

Well, what about thumb sucking, you may ask.

That my friends, is a whole different story.

We will talk about that tomorrow.

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My crown just fell off?!

You are eating a meal and all of a sudden you feel something crunchy.

You search for the crunchy item with your tongue and pull it out.

Its one of your crowns!

You don't know how it happened but it just came off.

First Rule: Do not panic.

Crowns can come off for several reasons.

Some of these reasons are very very easy to fix.

So just because your crown came off does not mean that its the end of the world.

First thing to do is to look into the crown.

If its empty then things are real good.

This means that the cement that holds the crown on simply broke loose and you just need to get it re-cemented.

If there is a bunch of stuff in the tooth then you may have a little more of a problem on your hands.

What is in the crown may be fragment of the tooth. If there are a lot of fragments then you may need to have a new crown made due to the fact that that one may not fit any longer.

So until you can get to the dentist to find out exactly what your case is what can you do.

Try to stick it back on.

If it fits snuggly then you may just be able to baby it until you get in to the dentist.

If it fits loosely then you can simply put a bit of toothpaste into it and then stick it back on.

The toothpaste will make up the difference in the fit of the crown and help keep it on.

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Cracked tooth?

Lets see if this is you.

Your tooth hurts, but only sometimes.

Its not sensitive to changes in temperature.

It hurts to bite on things but only every once in a while.

You have asked your dentist but they can't find anything wrong with it.

You may have a cracked tooth.

Cracks are not always visible by the dentist.

It takes some time and investigation to find them.

Once found however, depending on the severity of the crack, they can be fairly easy to fix.

So if you find yourself having random tooth pain that is driving you crazy, consult your dentist about whether or not your tooth could be cracked.

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Impacted wisdom teeth II.

So you are afraid to get your wisdom teeth out?

And the avenue you have chosen to avoid this surgery is to leave them in.

Here is just one example of what can happen if you chose to do that.

What you have on the right is an x-ray of an angled wisdom tooth that is trying to come through the tissue.

It was trying so hard in fact that it dug a hole right into the side of the tooth next to it.

So not only does the wisdom tooth need to come out but now the other tooth needs to come out as well.

If this were to repeat itself in your mouth 4 times (once for every wisdom tooth) you would need to go through 8 extractions instead of 4.

Still think its a good idea NOT to take out your wisdom teeth?!

Didn't think so.

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Impacted wisdom teeth.

When people talk of wisdom teeth stories often surface of friends or family that have had "impacted" wisdom teeth. This word is used as the end all of dental stories. If your wisdom teeth were impacted then everyone feels horribly for you and you are the winner of nightmare dental stories.

Well, we need to dive a little further into this idea of impaction before we anoint anyone as having had the worst dental experience ever.

For you see, not all impactions are the same.

The word impacted simply means, stuck or wedged. If your 2 year old puts their head in between a railing that is too small for them and they can't pull their head out, then technically your child's head is impacted.

Many wisdom teeth become impacted simply because there is not enough room between the back tooth and the jaw bone. If the tooth is in a vertical position, similar to the other teeth, then this is called a vertical impaction. This situation is easily solved by simply shaving a small portion of bone out from around the tooth and allowing the tooth the necessary room to come out.

But what if your tooth is not in a horizontal position?

What if its tipped a little?

What if its tipped a lot?

What if its laying completely on its side!?

As the wisdom tooth tips further and further over it gets harder and harder to take out.

If its laying completely on its side, then my friends, you have what's called a horizontal impaction.

If you happen to have, or had, a horizontal impaction then you may then declare yourself the winner, at your dinner parties, as having the most horrible wisdom teeth at the table.

Below are examples of different types of impactions.

So as you can see.

Not all impactions are the same.

So, if if its going to be bad taking them out then lets just leave them in........ right?

Um...... No. Tune in tomorrow when we will see what can happen if you choose that route.

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Discolored tooth?

I, and/or my child, have one tooth that is not the same color.

Should I be concerned?

Well, lets just say its a good idea to get it checked out.

Teeth discolor for a number of reasons.

If all of your teeth are discoloring at the same rate then it is more then likely due to staining

caused by foods you eat and/or oral habits you may have suck as smoking.

In that case there is not much to worry about.

Simple whitening can take care of that.

If you notice that one individual tooth is turning a different color then there is more cause for concern. One tooth discoloring on its own typically means that that tooth has moderate to severe nerve damage. This nerve damage can be caused by trauma, decay, or other causes. but regardless of the cause it is more then likely that the nerve is dead, or dying, and needs to be removed. This procedure is called a root canal. After the root canal is preformed then some sort of cosmetic procedure may be needed to restore the original color of the tooth. This may be a crown, veneer or cosmetic bonding.

Not many people realize it, but teeth are living organisms. They have blood coursing through the middle of them and just like any other living think they can die. If they do die then one of the number one signs of that death is a change in color.

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Do you judge people?

You are being judged.

Like or not it is happening everyday.

One of the things that people use to judge you is your teeth.

Lets give you an example.

This is Carl.

Without taking a lot of time to think about it, come up with 3 words that you would use to describe Carl.

I am purposefully leaving this space blank so you have to scroll down to see Carl's "after" picture.

Keep Scrolling

Keep Scrolling

Keep Scrolling

Okay.

Here is Carl after he got his new teeth.

Now, think of 3 words to describe Carl.

Are you using the same words to describe Carl now as you were when you saw the first picture?

Like it or not people will judge you by your smile.

I would be nice if they didn't but they do.

Employers, relationships, family, neighbors, c0-workers, etc. may all make judgments about who you are because of your smile.

No matter the reasons for your tooth loss you don't have to remain that way. Show the world the great smile that you have on the inside by showing off a great smile on the outside.

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Its just a little cavity. I think?

If you ever look in your mouth and are able to SEE any color other then the white of your teeth you need to get it looked at.

It may just be stain or last nights dinner but it could be a sign of something much more.

When a dentist looks at your teeth he/she uses color change as one of the indicators to take a closer look at any particular area.

The pictures below are a case that we did just this morning.

The patient came in with a little darkened area on one of his molars.

After we got done getting out all of the decay out he was as close as you would ever want to come to getting a root canal. Once the decay gets down into the tooth you are no longer able to get to it with your toothbrush, floss or mouthwash. The bacteria simply set up shop in your tooth and start to multiply. Not Good.

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Stop Sipping!!!

We see it all the time.

People coming into the office with with their teeth hurting.

I tell them that they have a ton of cavities and they tell me that that is impossible.

Since nothing is impossible I ask them why they think that.

They tell me its because they only drink 1 can of soda pop a day.

I tell them that that's not so bad and that lots of people have a soda at some point during the day.

I then ask them how long it takes them to drink it.

They tell me that they sip on it throughout the day and that it takes them about 4 hours to finish off a can.

Here in lies our problem.

Cavities caused by soda happen due to the time that the teeth are exposed to the sugar and not the amount of sugar ingested.

If I drank an entire 2 liter of Mountain Dew for breakfast and my patient only had 1 can on Mountain Dew but it took him 4 hours to drink his can, who do you think would be worse off?

If you said the guy drinking the can then you are starting to catch on.

Although my sugar content is higher and I may experience more symptoms throughout my body my teeth are much better off. I get the sugar in my mouth and then get it out and I am done. The person who sips on that one can for hours at a time has sugar covering their teeth all the whole time they are sipping. So less sugar but more tooth exposure.

Moral of the story is DO NOT SIP!

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Bulimia, acid reflux, sucking on lemons

Teeth are like similar to anything else in the fact that they can be eroded by acid.

Acids can come from external or internal sources.

A good example of an internal acid source would be Acid Reflux. Most acid reflux will cause mild to moderate cases of heart burn. The stomach acid will travel up the esophagus toward the mouth. It usually makes it only as high as the level of the heart and this is what causes a sensation that the area around your heart is burning. If the Acid Reflux is more severe it the acid will make it all the way to the mouth. When in the mouth the acids will eat away at the enamel of the teeth.

Another example of internal acid is the condition known as Bulimia. This is where individuals will induce vomiting as a way of losing weight. After eating they want to rid themselves of the food they just ingested before it gets absorbed into the body. As they induce vomiting not only does the food come up but stomach acids will come up also.

An example of external acids would be sucking on things like lemons or other acidic foods. Many Carbonated beverages are also very high in acid. These acids may not be as strong as acids from the stomach but if the exposure is consistent over a long enough period of time the effects can be just as damaging.

This picture illustrates the effects of acid against your teeth over time.

The tooth should be covered in white. That is the protective layer of the tooth known as enamel. Where the teeth have a more yellow appearance is where the acids have eaten away the enamel. The yellow portion is the layer beneath the enamel which is much softer and much more susceptible to decay. These teeth will need to be crowned quickly to avoid decay from reaching the nerve and the need for root canals.

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Tongue Piercing

You see it all the time.

People with barbells sticking out their tongue.

You may even have one yourself.

But is it safe?

In a word...... NO!

Can you feel a stray hair on your arm? Probably not.

Can you feel a stray hair on your leg? Again, probably not.

Can you feel a hair in your mouth? Absolutely.

The reason for this is because the tongue has more nerves contained in it then almost any other part of your entire body. It is very sensitive and very precise. Therefore, ramming a large steel rod through it will certainly damage these nerves. Piercing the tongue can lead to loss in ability to feel your tongue and ability to taste food.

Besides loss of taste and feel there are also other dangers.

Since the mouth can not be kept sterile, as other parts you may pierce,

the chance of infection is greater. The above picture is a very nicely infected tongue.

Cracking your teeth on a tongue ring is also a very real concern. I have treated many cracked teeth from people biting down on tongue rings.

Want another reason?

How about this one.

If you catch your tongue ring on something. You can actually pull it out of your tongue and cause, this......

Look Fun????

My suggestion, DON'T DO IT!!!

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Electric Toothbrushes

Okay, because you asked.

When the topic of electric toothbrushes comes up there are two big questions that I always get asked.

Questions.

#1 Do I need one.

#2 Which one is the best.

Answers

#1 No. You do not need an electric tooth brush. If you are a diligent brusher then it does not really matter if your tooth brush uses batteries for power or uses you for power. The results can be the same. This is not to say that the results will be the same in the same amount of time. Because they wont. The manual tooth brush will take a little longer but it is capable of doing the same thing.

# 2 This question is like asking which car is the best. Well, a Ferrari is the fastest and looks the best, but a Toyota Camry will do you just fine. The same is true for tooth brushes. There are tooth brushes out there that can run you over $300. They have timers to tell you when to stop. they will talk to you and tell you to switch sides of the mouth. They have pressure sensors to tell you if you are brushing too hard. And they look really cool. However, the electric toothbrushes that cost $10 can do just as much for cleaning your teeth. The whole idea behind cleaning your teeth is just to get the bristles to remove the plaque. Little timers are nice but if you are capable of getting your teeth clean without a timer then what is the point.

So what do I use?

I use an Oral B electric. I like the way it feels when it cleans and it seems to work well for me. My wife uses a Sonicare, and can't stand my Oral B. Conversely I have used her Sonicare and that thing drives me up the wall. So there is a lot to be said here about personal preference.

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