Posts for: February, 2020
Even though teeth are resilient, they're not indestructible. An accidental collision involving the face could damage teeth, even knocking a tooth completely out of its socket.
At first, it might seem like the end of the line for that particular tooth. But it doesn't have to be—if you know what to do. But you'll have to act quickly: The longer the tooth is out of its socket, the less chance it will survive long-term.
Here are the steps you should take to save a knocked-out tooth.
Find the tooth. It's important that you locate the missing tooth quickly. When you do, don't handle it by the root end: It still contains delicate periodontal cells that are essential if the tooth is going to rejoin with the ligaments and bone. Use clean water to rinse off any dirt or debris.
Reinsert the tooth. Holding it by the crown and not the root, reinsert the tooth into its empty socket, hopefully within an hour (the faster the better). You want to make sure it's good and snug, so apply a little force when you do this. Place some clean gauze or cloth between the tooth and its opposite on the other jaw, then have the person bite down and hold it in place.
Get immediate dental care. It's preferable to find a dentist as soon as possible (if not, then the nearest emergency medical facility). The dentist will x-ray the tooth to make sure it's positioned properly, and may adjust it further if necessary. They may also splint the tooth to adjacent teeth to help stabilize it until it fully reattaches with the jaw.
Again, time is of the essence—the quicker you can perform the above steps, the better the tooth's chances. Any delay could jeopardize the tooth's ability to reattach, or it could shorten its lifespan.
You can also get guidance on treating a knocked-out tooth and other dental emergencies with a free mobile app developed by the International Association of Dental Traumatology (IADT). Just look in your Android or IOS app store for ToothSOS.
If you would like more information on what to do during a dental emergency, 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 “When a Tooth is Knocked Out.”
Surgical tooth extraction is a fairly routine procedure with few complications. But one rare complication called dry socket does affect a small number of patients. Dry socket, which derives its name from its appearance, can be quite painful. Fortunately, though, it doesn't pose a danger to oral health.
Normally after a surgical extraction, a blood clot forms in the empty socket. This is nature's way of protecting the underlying bone and nerves from various stimuli in the mouth as well as protecting the area. Sometimes, though, the clot fails to form or only forms partially (almost exclusively in lower wisdom teeth), exposing the sensitive tissues beneath the socket.
Patients begin to notice the painful effects from a dry socket about three or four days after surgery, which then can persist for one to three more days. Besides dull or throbbing pain, people may also experience a foul odor or taste in their mouth.
People who smoke, women taking oral contraceptives or those performing any activity that puts pressure on the surgical site are more likely to develop dry socket. Of the latter, one of the most common ways to develop dry socket is vigorous brushing of the site too soon after surgery, which can damage a forming blood clot.
Surgeons do take steps to reduce the likelihood of a dry socket by minimizing trauma to the site during surgery, avoiding bacterial contamination and suturing the area. You can also decrease your chances of developing a dry socket by avoiding the following for the first day or so after surgery:
- brushing the surgical area (if advised by your surgeon);
- rinsing too aggressively;
- drinking through a straw or consuming hot liquid;
If a dry socket does develop, see your dentist as soon as possible. Dentists can treat the site with a medicated dressing and relieve the pain substantially. The dressing will need to be changed every few days until the pain has decreased significantly, and then left in place to facilitate faster healing.
While dry sockets do heal and won't permanently damage the area, it can be quite uncomfortable while it lasts. Taking precautions can prevent it—and seeing a dentist promptly if it occurs can greatly reduce your discomfort.
If you would like more information on oral surgery, 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 “Dry Socket: A Painful but Not Dangerous Complication of Oral Surgery.”
The ongoing opioid addiction epidemic has brought together government, law enforcement and healthcare to find solutions. The focus among doctors and dentists has been on finding ways to reduce the number of opioid prescriptions.
Opioids (or narcotics) have been a prominent part of pain management in healthcare for decades. Drugs like morphine, oxycodone or fentanyl can relieve moderate to extreme pain and make recovery after illness or procedures much easier. Providers like doctors and dentists have relied heavily on them, writing nearly 260 million narcotic prescriptions a year as late as 2012.
But although effective when used properly, narcotics are also addictive. While the bulk of overall drug addiction stems from illegal narcotics like heroin, prescription drugs also account for much of the problem: In 2015, for example, 2 million Americans had an addiction that began with an opioid prescription.
The current crisis has led to horrific consequences as annual overdose deaths now surpass the peak year of highway accident deaths (just over 54,000 in 1972). This has led to a concerted effort by doctors and dentists to develop other approaches to pain management without narcotics.
One that’s gained recent momentum in dentistry involves the use of non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs like acetaminophen, ibuprofen or aspirin work by dilating blood vessels, which reduces painful inflammation. They’re available over the counter, although stronger doses require a prescription.
NSAIDs are effective for mild to moderate pain, but without the addictive properties of narcotics. There are some adverse health consequences if taken long-term, but limited use for pain or during post-procedure recovery is safe.
Many dentists are recommending NSAIDs for first-line pain management after most dental procedures. Narcotics may still be prescribed, but in a limited and controlled fashion. As part of this new approach, dentists typically combine ibuprofen and acetaminophen: Studies have shown the two work together better at reducing pain than either one individually.
Still, many aren’t eager to move away from the proven effectiveness of narcotics to primarily NSAIDs. But as these non-addictive drugs continue to prove their effectiveness, there’s hope the use of addictive opioids will continue to decrease.