Help! I Broke my Tooth!

Almost every day we get a call from a patient who has broken a tooth, and generally it means that to save the tooth, we have to place a crown or permanent restoration over it to keep it from breaking further. Sometimes the tooth can't be saved and that is a real bummer!

What causes teeth to break? Well, there are several factors, one of which we see in almost all tooth fractures. The most common contributing factor is Silver amalgam fillings- these fillings have the unique property of enlarging as they age. So, there seems to be some outward pressure on the tooth and if someone bites just the right (or wrong) way, you hear that crack!

Now this tooth broke in several planes at once, and had to be removed; there wasn't enough sound tooth structure to save it! So an implant or bridge needed to be done.

This is a more common sort of fracture. The inside aspect of the tooth just shears away. Luckily, this tooth can be saved with a crown, after first making sure there is no decay present.

The second common factor is bruxism- the habit of grinding or clenching the teeth. Many bruxers break teeth that don't even have fillings in them, but they always have a higher percentage of broken teeth than people who don't brux or clench.

If you or someone you know does grind their teeth and are worried about a tooth or some teeth, don't hesitate to give us a call and we will be glad to check it out for you! Don't wait until it hurts!

For more information, or to schedule a cleaning, call your favorite Williamsburg dentist, Dr. James A. Burden, at (757) 941-7079!

Handling Dental Emergencies

Dental emergencies may be categorized as toothaches, injuries or broken appliances.

Toothache If a toothache develops, using a brush and floss, clean the suspected area. Rinse with warm salt water. Do not place an aspirin on the gums or tooth [this may cause a burn]. Apply a cold compress to any facial swelling. Take acetaminophen [Tylenol] and call us as soon as possible.

Avulsed Tooth If a permanent tooth is knocked completely out, time is of the essence. Immediately call us for an emergency appointment. It is critical to get the person and their tooth to us within one half hour. This makes it possible to re-implant the tooth with a high degree of success. Find the tooth, and holding it by its crown, gently rinse it to remove dirt and/or debris. Do not scrub the tooth. If possible, gently place the tooth back in its socket as a means of transport. Otherwise, transport the tooth in a cup of milk, saline [salt water], or saliva [place tooth between cheek and gum, unless child is too young]. If none of these are available, use a cup of plain water.

Extruded Teeth If a tooth is pushed either inward or outward, try to reposition the tooth using light finger pressure. Do not force the tooth into its socket. Try to get the injured person to us as soon as possible. The tooth may be stabilized and held in place with a moist tissue or gauze on the way over.

Fractured Teeth First rinse your mouth with warm water to keep it clean. Immediate dental care is necessary. The treatment will depend on the severity of the fracture and could range from smoothing out the chip to bonding with a resin [tooth colored] material to placing a crown [cap]. If there has been pulp [nerve] injury, root canal may be necessary at once or at a later date.

Soft Tissue Injury The tongue, lips or cheeks may be bitten, lacerated [cut] or punctured. If there is bleeding, apply firm pressure with a gauze or clean cloth. If bleeding doesn’t stop within 15 minutes, bring the person to our office or a hospital emergency room. Sutures [stitches] may be necessary. Otherwise, clean the area with warm water on a gauze or clean cloth. Apply an ice compress to the bruised or swollen area. Contact us for further instructions.

For more information, or to schedule a cleaning, call your favorite Williamsburg dentist, Dr. James A. Burden, at (757) 941-7079!

"Here, use my toothbrush..."

Ever use someone else's toothbrush? You may think twice about doing it again after reading this: (1) Toothbrushes can be a source of repeated dental infections. (2) Toothbrushes can cause a bacteremia (bacteria entering the bloodstream) that may result in an endocarditis (a heart infection). (3) Toothbrushes can harbor and transmit viruses and bacteria. (4) Toothbrushes can retain 50% of the herpes simplex virus for one week. (5) Gingival [gum] inflammation can be reduced by changing toothbrushes biweekly.

Still think it's sexy to share a toothbrush? How about sharing food? Kissing? Certain bacteria can be transmitted from site to site in the mouth via dental instruments or from person to person sharing someone else's eating utensil. In juvenile periodontitis, virulent bacteria can move from an infected site to an uninfected site in the same mouth. Other bacteria can be transmitted between spouses. Some bacteria can be transmitted between parents and children. Still other bacteria can be transmitted from dogs to children.

So you see, bacteria once thought to be localized to specific sites in the mouth can be migratory. We're not advocating that you stop tasting a scrumptious morsel or two at a four-star restaurant; we are advocating that everyone maintain good dental health not only for themselves but for the sake of those they love.

As far as ridding toothbrushes of bacteria, soaking them in a mouthrinse containing essential oils for 20 minutes kills 100% of the bacteria on the bristles. Ultraviolet light also sanitizes toothbrushes. But when researchers* tested the efficacy of using a toothpaste containing a common disinfectant compound - triclosan - they found little benefit when it came to eliminating the offending bacteria attached to the toothbrush bristles.

So what can you do about bacterial contamination from toothbrushes? Soak them in a suitable mouthwash, expose them to ultraviolet light, or from a practical stance, change them frequently. As for kissing someone, the benefits may still outweigh the risks... as long as you have an inkling as to their periodontal status!

*Warren DP, Goldshmidt MC, Thompson MB, Adler-Storhz K, and Keene HJ: The effects of toothpastes on residual microbial contamination of toothbrushes. JADA 132:1241-1245, 2001.

For more information, or to schedule a cleaning, call your favorite Williamsburg dentist, Dr. James A. Burden, at (757) 941-7079!

Setting Priorities for Good Dental Health

Many people have bleeding gums, and they don’t think twice about it. They view it as a minor inconvenience. If you were bleeding from any other part of your body, you wouldn’t hesitate to see a physician. If you lost a body part you wouldn’t hesitate to have it replaced. We have 32 teeth - they are all body parts.

While we may not need our teeth to live like one needs a heart, we need our mouth to be pain-free and functional to enjoy a good quality of life.

But like exercising, dieting or anything that requires a routine, many of us fall short of a sustained effort to accomplishing long-term results. Why do we run out of toothpaste, floss, toothbrushes, vitamins, etc. when we know their importance? Why do we have problems maintaining an oral hygiene regimen? Perhaps, we don’t make the answers priorities.

We in this dental office believe in the philosophy espoused by Dr. F. Harold Wirth who said, "The mouth in its entirety is an important and even wondrous part of our anatomy, our emotion, our life; it is the site of our very being. When an animal loses teeth, it cannot survive unless it is domesticated; its very existence is terminated; it dies. In the human, the mouth is the means of speaking, of expressing love, happiness and joy, anger, ill temper, or sorrow. It is the primary sex contact; hence it is of initial import to our regeneration and survival by food and propagation. It deserves the greatest care it can receive at any sacrifice."

This is our passion. Make it yours and the rest will fall into place. Call and ask us how we may help you achieve your oral hygiene and health goals and ensure a greater quality of life.

For more information, or to schedule a cleaning, call your favorite Williamsburg dentist, Dr. James A. Burden, at (757) 941-7079!

Teeth Whitening

How we look and how we perceive ourselves has much to do with our self-esteem. When the color of our teeth makes us embarrassed to smile, it’s probably time to get our teeth whitened [bleached]. As one ages, teeth may darken from coffee, tea, smoking, berries and other substances that get into microcracks in the enamel causing discoloration. Some people have gray or brown bands on their teeth caused by an early childhood fever or tetracycline medication taken when the tooth enamel was forming. In some parts of the country where fluoride is found in natural high concentrations in the drinking water, individuals have developed teeth with bright white patches or dark brown blotches [mottled enamel or fluorosis]. Everyone is not a candidate for bleaching. Teeth discolored from aging have the best results. If you have tooth colored resin or composite fillings in your front teeth, they will not change color from bleaching and will “stick out like a sore thumb” after the procedure. If you would like to have your teeth whitened, call it to our attention at your next check-up visit. If you are not a good candidate, we can suggest alternatives such as bonding or porcelain veneers. There are various options to whitening your teeth. Bleaching is an at-home procedure wherein you will wear a custom-made mouth guard, filled with a bleaching gel, as per instructions from your dentist. Some toothpastes have added whitening agents and can be used as an adjunct to the other two procedures. In any case, there is no reason to ever again suffer the embarrassment of discolored teeth.

For more information, or to schedule a cleaning, call your favorite Williamsburg dentist, Dr. James A. Burden, at (757) 941-7079!

Gum Chewing: Helpful or Harmful?

While there is no question that regular chewing gum promotes tooth decay, there is clinical evidence that demonstrates just the opposite for sugar-free gum. Studies have shown that using sugar-free chewing gum after meals and snacks, especially when toothbrushing at those times is impractical, helps reduce the acid level and its potential detrimental effect on the enamel. Its mechanism of action is the stimulation of 10 times the normal rate of salivary flow due to both the act of chewing and the flavor of the artificial sweetener (sorbitol or xylitol). The saliva washes away food particles and acid produced by bacteria in the plaque and neutralizes the acid because of increased concentration of bicarbonates. Chewing sugar-free gum is not intended to replace toothbrushing and flossing. Sugar-free gum is also recommended for people with xerostomia (dry mouth) to stimulate increased salivary flow, along with drinking greater amounts of water (6-8 glasses a day). However, those experiencing TMD (temporomandibular joint disorder) symptoms should refrain from chewing any gum.

For more information, or to schedule an appointment, call your favorite Williamsburg dentist, Dr. James A. Burden, at (757) 941-7079!

Benefits of Maintaining Your Teeth

Most people know that maintaining good dental health into old age has many benefits. Those most important include comfort of the teeth and gums, the ability to enjoy food, and a better appearance.

Studies have shown that those individuals who have poor dental health have a higher mortality rate than those who were in better dental health. Moreover we can point to the impact of nutrition as the most likely contribution to health.

The elderly like younger patients should see their dentist at least twice a year for check ups and cleanings. All cavities, gum disease, and other dental infections should be treated promptly. Patients wearing full or partial dentures should have them evaluated for proper comfort and fit. Dentures that have been worn for many years may not fit well anymore. This happens because the jawbone under the denture can become worn away over time.

Loose dentures make it difficult to eat, speak, and do not support the face as well. A loose denture begins to need more and more adhesive to stay in place. Your dentist can sometimes remedy the problem by relining the denture, but a new denture should be made about every 5 to 7 years, or when the dentures cannot be used comfortably. In some cases, implants can be used to help secure the dentures. This is usually needed in the lower jaw and is sometimes the only way to help the patient stabilize and use their denture.

Remember, maintaining good dental health along with proper nutrition is a key factor in living a long healthy life.

For more information, or to schedule a cleaning, call your favorite Williamsburg dentist, Dr. James A. Burden, at (757) 941-7079!