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Posts for: November, 2014

By Timothy T. Bui, D.D.S., Inc.
November 19, 2014
Category: Oral Health
Tags: oral health   dental injury  
TheTimeIntervaltoReplantaKnockedOutToothCanAffectitsLongevity

Contrary to what you might think, a knocked out tooth doesn’t inevitably mean tooth loss. Time is of the essence — the shorter the interval between injury and replanting the tooth, the better the tooth’s long-term survival. The longer the interval, on the other hand, the less likely the tooth can survive beyond a few years. That phenomenon is due to the mouth’s natural mechanism for holding teeth in place.

The tooth root maintains its attachment with the jaw bone through an intermediary tissue known as the periodontal ligament. Tiny fibers from one side of the ligament securely attach to the tooth root, while similar fibers attach to the bone on the opposite side of the ligament. This maintains stability between the teeth and bone while still allowing incremental tooth movement in response to mouth changes like tooth wear.

While the ligament fibers will attempt to reattach to a replanted tooth’s root, the longer the tooth is out of the socket the less likely the fibers will fully reattach. An “ankylosis” may instead form, in which the root attaches directly to the jaw bone without the periodontal ligament. In this situation the body no longer “recognizes” the tooth and begins to treat it like a foreign substance. In all but the rarest cases, the tooth root will begin to resorb (dissolve); at some point (which varies from patient to patient) the attachment becomes too weak for the tooth to remain in place and is lost.

Ideally, a knocked out tooth should be replanted within 5 minutes of the injury (for step-by-step instructions, refer to The Field-Side Guide to Dental Injuries available on-line at www.deardoctor.com/dental-injuries). Even if you pass the 5-minute window, however, it’s still advisable to attempt replanting. With a subsequent root canal treatment (to remove dead tissue from the inner tooth pulp and seal it from infection), it’s possible the tooth can survive for at least a few years, plenty of time to plan for a dental implant or similar tooth replacement.

If you would like more information on treatment for a knocked out tooth, 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 “Knocked Out Tooth.”


By Timothy T. Bui, D.D.S., Inc.
November 03, 2014
Category: Dental Procedures
Tags: celebrity smiles  
JohnStamosBritneySpearsandHowtoRelaxDuringDentalTreatment

We're always tickled to see dentists represented in popular culture, especially when portrayed by an actor as handsome as John Stamos. On the hit television show Glee, Stamos played a dentist who made sure the glee club members cleaned up their act when it came to oral hygiene — though perhaps he used a bit too much anesthesia to achieve this admirable goal. While under his care — and lots of sedation — several Glee characters had music-infused hallucinations in which they danced and sang with pop star Britney Spears.

Far-fetched? No doubt. Still, it's worth mentioning that sedation has its place in dentistry. In fact, if you are someone who tends to get anxious or even fearful about dental treatment, you should know that sedation can help you relax both mind and body so you can feel peaceful rather than anxious in the dentist's chair. And that's the whole point: Fear of pain should not stand in the way of your getting the care that will keep you healthy and allow you to keep your teeth for as long as possible.

You may not know this, but when you are afraid, your threshold for pain is actually lower. You become hypersensitive to every sensation and sound, and you tense your muscles. Fear and anxiety trigger the release of certain chemicals that put you in “fight or flight” mode. In this heightened state of alert you experience more pain during and even after treatment.

The good news is that this response can virtually be eliminated with various oral sedatives and/or with nitrous oxide, which is inhaled. Both treatments will allow you to let your guard down and relax. Your apprehension and hypersensitivity to pain will disappear, even though you are still conscious. And when you are relaxed, we are better able to focus on the task at hand, knowing that you are comfortable.

The sedatives used in dentistry have been subjected to rigorous testing and have a strong safety record backed by decades of use. Several even have “amnesic” properties, meaning that you will remember little to nothing of your treatment — unless, of course, you end up singing and dancing with Britney Spears!

If you would like more information about sedation in dentistry, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Oral Sedation Dentistry.” Dear Doctor also has more on “Overcoming Dental Fear & Anxiety.”