How Can I Brighten My Smile?
Your wedding is coming up, and you want your smile to be its brightest. Or maybe you have an important speaking engagement. Whatever the reason, tooth bleaching isn't just for movie stars, and it isn't just for one day. Many people have had their teeth bleached, and probably millions more are thinking about it. The desire for a brighter smile with whiter teeth is very strong, and tooth bleaching safely lightens the color of the teeth, lasting for up to five years. The most effective and safest method of tooth bleaching is dentist-supervised.
Generally, bleaching is successful in at least 90 percent of patients, though it may not be an option for everyone. Consider tooth bleaching if your teeth are darkened from age, coffee, tea or smoking. Teeth darkened with the color of yellow, brown or orange respond better to bleaching. Gray stains caused by fluorosis, smoking or tetracycline use can be lightened, but results are not as dramatic. If you have very sensitive teeth, periodontal (gum) disease or teeth with worn enamel, your dentist may discourage bleaching.
Updated: February 2007
What's Involved?
First, the dentist will determine whether you are a candidate for tooth bleaching and what type of bleaching system would provide the best results. If you're in a hurry for whiter teeth, you may decide to have your teeth lightened immediately. Your dentist will use either an in-office bleaching system or laser bleaching while you sit in the dental chair. Some patients choose dentist-supervised at- home bleaching, which is more economical and provides similar results.
If you don't choose laser bleaching, at your next appointment your dentist or hygienist will make impressions of your teeth to create a mouthguard appliance. The mouthguard is custom-made for your mouth and is lightweight so that it can be worn comfortably while you are awake or sleeping. The mouthguard is so thin that you should even be able to talk and work while wearing it. Along with the mouthguard, you'll receive the bleaching materials. You'll be given instructions on how to wear the mouthguard.
Some bleaching systems recommend bleaching your teeth for several hours a day. Generally this type of system requires two to four weeks to complete. Other systems recommend bleaching at night while you sleep. This type of system usually requires only 10 to 14 days to complete.
Over-the-counter bleaching systems are also available and are generally safe and effective, although it is best to check with your dentist before using these products. These systems, which come in the form of strips and gels, usually contain a lower strength of bleaching agent than products used in the dentist's office. For this reason, they must be used longer to achieve a desired effect, but they are also cheaper.
Updated: October 2008
How it Works and Safety
Lightness should last from one to five years, depending on your personal habits such as smoking and drinking coffee and tea. At this point you may choose to get a touch-up. The retreatment time is much shorter than the original treatment time.
The active ingredient in most of whitening agents is carbamide peroxide; when water comes into contact with this white crystal, the release of hydrogen peroxide lightens the teeth.
Several studies have proven bleaching to be safe and effective. The American Dental Association has granted its seal of approval to some tooth bleaching products. Some patients may experience slight gum irritation or tooth sensitivity, which will resolve when the treatment ends.
Updated: October 2008
Create Realistic Expectations
No one can really predict how much lighter your teeth will become. Every case is different. Typically, there is a two-shade improvement as seen on a dentist's shade guide. The success rate depends upon the type of stain involved, the type of bleaching procedure and your compliance. Bleaching can only provide a shift in color from gray to a lighter shade of gray, for example. Bleaching does not lighten artificial materials such as bonding or veneers.
Updated: October 2008
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com
What are Crowns?
A crown is a restoration that covers, or "caps," a tooth to restore it to its normal shape and size, strengthening and improving the appearance of a tooth. Crowns are necessary when a tooth is generally broken down and fillings won't solve the problem. If a tooth is cracked, a crown holds the tooth together to seal the cracks so the damage doesn't get worse. Crowns are also used to restore a tooth when there isn't enough of the tooth remaining to provide support for a large filling, attach a bridge, protect weak teeth from fracturing, restore fractured teeth or cover badly shaped or discolored teeth.
How is a crown placed?
To prepare the tooth for a crown, it is reduced so the crown can fit over it. An impression of the teeth and gums is made and sent to the lab for the crown fabrication. A temporary crown is fitted over the tooth until the permanent crown is made. On the next visit, the dentist removes the temporary crown and cements the permanent crown onto the tooth.
Will it look natural?
Yes. The dentist's main goal is to create a crown that looks like a natural tooth. That is why your dentist takes an impression. To achieve a certain look, a number of factors are considered, such as the color, bite, shape and length of your natural teeth. Any one of these factors alone can affect your appearance.
If you have a certain cosmetic look in mind for your crown, discuss it with your dentist at your initial visit. When the procedure is complete, your teeth will not only be stronger, but they may be more attractive.
Why crowns and not veneers?
Crowns require more tooth structure removal, hence they cover more of the tooth than veneers. Crowns are customarily indicated for teeth that have sustained significant loss of structure or to replace missing teeth. Crowns may be placed on natural teeth or dental implants.
What is the difference between a cap and a crown?
There is no difference between a cap and a crown.
How long do crowns last?
Crowns should last approximately five to eight years. However, with good oral hygiene and supervision, most crowns will last for a much longer period of time. Some damaging habits like grinding your teeth, chewing ice or fingernail biting may cause this period of time to decrease significantly.
How should I take care of my crown?
To prevent damaging or fracturing the crown, avoid chewing hard foods, ice or other hard objects. You also want to avoid teeth grinding. Besides visiting your dentist and brushing twice a day, cleaning between your teeth is vital with crowns. Floss or interdental cleaners (specially shaped brushes and sticks) are important tools to remove plaque from the crown area where the gum meets the tooth. Plaque in that area can cause dental decay and gum disease.
Updated: January 2007
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com
What are Veneers?
Veneers are ultra-thin shells of ceramic (porcelain) or a composite resin material, which are bonded to the front of teeth. This procedure requires little or no anesthesia and can be the ideal choice for improving the appearance of the front teeth. Veneers are placed to mask discolorations, to brighten teeth and to improve a smile.
Veneers are an excellent alternative to crowns in many situations. They provide a much more conservative approach to changing a tooth's color, size or shape. Veneers can mask undesirable defects, such as teeth stained by tetracycline and damage due to an injury or as a result of a root-canal procedure. They are ideal for masking discolored fillings in front teeth. Patients with gaps between their front teeth or teeth that are chipped or worn may consider veneers. Generally, veneers will last for many years, and the technique has shown remarkable longevity when properly performed.
Updated: October 2008
Process for Getting Veneers
Patients may need up to three appointments for the entire procedure: diagnosis and treatment planning, preparation and bonding.
It's critical that you take an active role in the smile design. Spend time in the planning of the smile. Understand the corrective limitations of the procedure. Have more than one consultation, if necessary, to feel comfortable that your dentist understands your objectives.
To prepare the teeth for the veneers, the teeth are lightly buffed to allow for the small added thickness of the veneer. Usually, about half a millimeter of the tooth is removed, which may require a local anesthetic. Composite resin veneers are generally done in one appointment. After the tooth is prepared, the dentist carefully bonds and sculpts the composite material onto your teeth. For ceramic veneers, a mold is taken of the teeth, which is sent to the laboratory for the fabrication of the veneers. This may take several days. If the teeth are too unsightly, a temporary veneer can be placed, at an additional cost.
When your ceramic veneers are ready, the dentist places each veneer on the teeth to check their fit and get a sense of the shade or color. While the veneers are resting on your teeth, view the results, and pay particular attention to the color. At this point, the color of the veneers can still be adjusted with the shade of the cement to be used. The color cannot be altered after veneers are cemented. To apply the veneer, the tooth is cleansed with specific chemicals to achieve a bond. Once a special cement is sandwiched between the veneer and tooth, a light beam hardens the cement.
Updated: October 2008
What to Expect with Veneers
For about a week or two, you will go through a period of adjustment as you get used to your "new" teeth that have changed in size and shape. Brush and floss daily. After one or two weeks, your dentist will ask you to return for a follow-up appointment.
Veneers are reasonable facsimiles of natural teeth, not perfect replacements. It's not uncommon to see slight variations in the color of veneers upon close inspection, as this occurs even in natural teeth. Nevertheless, this procedure can greatly enhance your smile and can heighten self-esteem.
Updated: October 2008
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com
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What are Bridges?
Bridges are natural-looking dental appliances that can replace a section of missing teeth. Because they are custom-made, bridges are barely noticeable and can restore the natural contour of teeth as well as the proper bite relationship between upper and lower teeth.
Bridges are sometimes referred to as fixed partial dentures, because they are semi-permanent and are bonded to existing teeth or implants. Some bridges are removable and can be cleaned by the wearer; others need to be removed by a dentist.
Porcelain, gold alloys or combinations of materials are usually used to make bridge appliances.
Appliances called implant bridges are attached to an area below the gum tissue, or the bone.
What is a Dental Implant?
A dental implant is an artificial tooth root that is surgically anchored into your jaw to hold a replacement tooth or bridge in place. The benefit of using implants is that they don't rely on neighboring teeth for support and they are permanent and stable. Implants are a good solution to tooth loss because they look and feel like natural teeth.
Implant material is made from different types of metallic and bone-like ceramic materials that are compatible with body tissue. There are different types of dental implants: the first is placed directly into the jawbone, like natural tooth roots; the second is used when the jaw structure is limited, therefore, a custom-made metal framework fits directly on the existing bone.
How do they work?
Strategically placed, implants can now be used to support permanently cemented bridges, eliminating the need for a denture. The cost tends to be greater, but the implants and bridges more closely resemble real teeth.
Can anyone receive dental implants?
Talk with your dentist about whether you are an implant candidate. You must be in good health and have the proper bone structure and healthy gums for the implant to stay in place. People who are unable to wear dentures may also be good candidates. If you suffer from chronic problems, such as clenching or bruxism, or systemic diseases, such as diabetes, the success rate for implants decreases dramatically. Additionally, people who smoke or drink alcohol may not be good candidates.
What can I expect during this procedure?
The dentist must perform surgery to anchor the "artificial root" into or on your jawbone. The procedure is done in the dental office with local anesthesia. The gum is then secured over the implant, which will remain covered until it fuses with the bone. The dentist then uncovers the implant and attaches an extension, or post, to the implant. With some implants, the implant and post are a single unit placed in the mouth during the initial surgery. Finally, the dentist makes an artificial tooth, or crown, that is attached to the implant post.
How long does the process take?
The process can take up to nine months to complete. Each patient heals differently, so times will vary. After the implant and posts are placed surgically, the healing process can take up to six months and the fitting of replacement teeth no more than two months. Sometimes, if a patient has good bone quality, posts can be placed and replacement teeth fitted in one appointment.
What is the success rate of implants?
The success rate for implants depends on the tooth's purpose and location in the mouth, as well as a patient's overall health.
How do I care for implants?
Poor oral hygiene is a big reason why some implants fail. It is important to floss and brush around the fixtures at least twice a day. Your dentist will give you specific instructions on how to care for your new implants. Additional cleanings of up to four times per year may be necessary to ensure that you retain healthy gums.
What is the cost of implants?
Since implants involve surgery and are more involved, they cost more than traditional bridgework. However, some dental procedures and portions of the restoration may be covered by dental and medical insurance policies. Your dentist can help you with this process.
Updated: February 2007
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com
What is a Denture?
A denture is a removable replacement for missing teeth and the tissues connected to those teeth. It is made of acrylic plastic and sometimes porcelain and metal materials. A denture closely resembles natural gum tissue and teeth.
Complete dentures replace all of the teeth, while partial dentures fill in the spaces created by missing teeth and prevent other teeth from shifting position. Complete dentures are "immediate" or "conventional." An immediate denture is a complete denture or partial denture that is inserted on the same day, immediately following the removal of the natural teeth. The immediate denture acts as a Band-Aid to protect the tissues and reduce bleeding after tooth extraction. The conventional denture is ready for placement in the mouth about 8 to 12 weeks after the teeth have been removed and the gum tissue has healed. However, some dentists may recommend more time before placing a conventional denture.
Who needs a denture?
A partial denture is for people who still have some of their natural teeth. Dentures are not just for elderly patients. Patients of any age may lose some or all of their teeth and may require a denture of some sort. Because teeth are a permanent part of the body, tooth loss can have an emotional impact on some people. It is important to talk to your dentist about any fears, anxiety, or other emotions you are feeling about tooth loss.
What happens when you get a denture?
A dentist can make a full conventional denture when all teeth have been lost or all extraction sites have healed (up to eight weeks or longer.) The denture process takes about one month and five appointments: the initial diagnosis is made; an impression and a wax bite are made to determine vertical dimensions and proper jaw position; a "try-in" is placed to assure proper color, shape and fit; and the patient's final denture is placed, following any minor adjustments.
New denture wearers need time to get accustomed to their new "teeth," because even the best-fitting dentures will feel awkward at first. While most patients can begin to speak normally within a few hours, many patients report discomfort with eating for several days to a few weeks. To get accustomed to chewing with a new denture, start with soft, easy-to-chew foods. In addition, denture wearers often notice a slight change in facial appearance, increased salivary flow or minor irritation or discomfort.
How do you care for a denture?
- Denture adhesives may be recommended, especially for the first-time denture wearer. Adhesives may improve the retention and stability of dentures for those with minimal bone support or small ridges. Stability of the denture will help the wearer's confidence.
- Remove and brush the denture daily with a denture cleanser and a brush (one specifically designed for cleaning dentures or a soft toothbrush).
- Avoid using boiling water to sterilize the denture, because hot water can cause the denture to lose its shape.
- If you wear a partial denture, remove it before brushing your natural teeth.
- When you're not wearing the denture, soak it in denture cleanser or water.
- To avoid misplacing your denture, store it in the same place after removal.
Should a denture be worn at night?
While you may be advised to wear your denture almost constantly during the first two weeks - even while you sleep - under normal circumstances it is considered best to remove it at night and soak the denture in cleansing solution or water. Research has shown that removing the denture for at least eight hours during either the day or night allows the gum tissue to rest and allows normal stimulation and cleansing by the tongue and saliva. This promotes better long-term health of the gums.
Continue seeing your dentist regularly
It is important to continue having regular dental checkups so that your dentist can examine oral tissues for signs of disease or cancer. With age, your mouth will continue to change as the bone under your denture shrinks or recedes. To maintain a proper fit over time, it may be necessary to adjust your denture or possibly remake your denture. Never attempt to adjust a denture yourself, and do not use denture adhesives for a prolonged period because this can contribute to bone loss. When in doubt, consult your dentist.
Are there any alternatives to dentures?
Dental implants are a possible alternative to dentures. Implants are artificial tooth roots that are surgically anchored into your jaw to hold a replacement tooth or bridge in place. Implants and bridges may resemble the "feel" of real teeth, but they may be more expensive than dentures. Not all patients are good candidates for implants, so be sure to talk to your dentist about which treatment option is best for you.
Updated: September 2008
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com
What is a Root Canal?
Underneath your tooth's outer enamel and within the dentin is an area of soft tissue called the pulp tissue. While a tooth's pulp tissue does contain nerve fibers, it is also composed of arteries, veins, lymph vessels, and connective tissue. Each tooth's nerve enters the tooth at the very tip of its roots. From there, the nerve runs through the center of the root in small "root canals," which join up with the tooth's pulp chamber. Root canals are very small, thin divisions that branch off from the top pulp chamber down to the tip of the root. A tooth has at least one but no more than four root canals.
Why do I feel pain?
When the pulp becomes infected due to a deep cavity or fracture that allows bacteria to seep in, or injury due to trauma, it can die. Damaged or dead pulp causes increased blood flow and cellular activity, and pressure cannot be relieved from inside the tooth. Pain in the tooth is commonly felt when biting down, chewing on it and applying hot or cold foods and drinks.
Why do I need root canal therapy?
Root canal therapy is necessary because the tooth will not heal by itself. Without treatment, the infection will spread, bone around the tooth will begin to degenerate and the tooth may fall out. Pain usually worsens until one is forced to seek emergency dental attention. The only alternative is usually extraction of the tooth, which can cause surrounding teeth to shift crookedly, resulting in a bad bite. Though an extraction is cheaper, the space left behind will require an implant or a bridge, which can be more expensive than root canal therapy. If you have the choice, it's always best to keep your original teeth.
What is a root canal procedure?
A root canal is a procedure done to save the damaged or dead pulp in the root canal of the tooth by cleaning out the diseased pulp and reshaping the canal. The canal is filled with a rubberlike substance called gutta percha or another material to prevent recontamination of the tooth. The tooth is then permanently sealed, with possibly a post and/or a crown made of porcelain or metal alloy. This enables patients to keep the original tooth.
What is involved in root canal therapy?
Once your general dentist performs tests on the tooth and recommends therapy, he or she can perform the treatment or refer you to an endodontist (a pulp specialist). Treatment usually involves one to three appointments.
First, you will probably be given a local anesthetic to numb the area. A rubber sheet is then placed around the tooth to isolate it. Next, an opening is drilled from the crown into the pulp chamber, which, along with the root canal, is cleaned of all diseased pulp and reshaped.
Medication may be inserted into the area to fight bacteria. Depending on the condition of the tooth, the crown may then be sealed temporarily to guard against recontamination, the tooth may be left open to drain or the dentist may go right ahead and fill the canals.
If you're given a temporary filling, usually on the next visit it's removed and the pulp chamber and canal(s) are filled with gutta percha or another material to prevent recontamination. If the tooth is still weak, a metal post may be inserted above the canal filling to reinforce the tooth. Once filled, the area is permanently sealed. Finally, a gold or porcelain crown is normally placed over the tooth to strengthen its structure and improve appearance.
What are the risks and complications?
More than 95 percent of root canal treatments are successful. However, sometimes a procedure needs to be redone due to diseased canal offshoots that went unnoticed or the fracture of a filing instrument, both of which rarely occur. Occasionally, a root canal therapy will fail altogether, marked by a return of pain.
What happens after treatment?
Natural tissue inflammation may cause discomfort for a few days, which can be controlled by an over-the-counter analgesic. A follow- up exam can monitor tissue healing. From this point on, brush and floss regularly, avoid chewing hard foods with the treated tooth, and see your dentist regularly.
Are there options to root canal therapy?
The only alternative to root canal therapy is to extract the tooth; however, this alone can cause the surrounding teeth to move, resulting in a bad bite. Though a simple extraction may be perceived as less expensive, the empty space left behind will require an implant or a bridge, which ultimately can be more costly than root canal therapy.
Updated: February 2007
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com
What is a Sealant?
A dental sealant is a thin plastic film painted on the chewing surfaces of teeth to prevent cavities.
How effective are sealants?
Studies have proven that properly applied sealants are 100-percent effective in protecting the tooth surfaces from cavities. As long as the sealant remains intact, small food particles and bacteria that cause cavities cannot penetrate through or around a sealant. Sealant protection is reduced or lost when part or all of the bond between the tooth and sealant is broken. However, clinical studies have shown that teeth that have lost sealants are no more susceptible to tooth decay than teeth that were never sealed.
Why can't I just brush and floss?
While brushing and flossing help to remove food particles and plaque from smooth surfaces of teeth, toothbrush bristles often can't reach into the teeth's depressions and grooves. Sealants protect those areas and prevent food and bacteria from getting in.
How are sealants applied?
Your dentist can apply sealants easily, and it takes only a few minutes to seal each tooth. The dentist first cleans the teeth that will be sealed, which may require the use of a dental drill to open the grooves of the teeth and determine if decay is present. Then he or she will roughen the chewing surfaces with an acid solution, which will help the sealant stick to the teeth. The dentist then "paints" the sealant on the tooth. It bonds directly to the tooth and hardens. Sometimes your dentist will use a special curing light to help the sealant harden. Sealant treatment is painless and takes anywhere from five to 45 minutes to apply, depending on how many teeth need to be sealed. Sealants must be applied properly for good retention.
How long will a sealant last?
As long as the sealant remains intact, the tooth surface will be protected from decay. Sealants hold up well under the force of normal chewing and usually last several years before a reapplication is needed. The risk of decay decreases significantly after sealant application. During your regular dental visits, your dentist will check the condition of the sealants and reapply them when necessary.
Who should receive sealant treatment?
Children, because they have newly erupted, permanent teeth, receive the greatest benefit from sealants. The chewing surfaces of a child's teeth are most susceptible to cavities. Surveys show that the majority of all cavities occur in the narrow pits and grooves of a child's newly erupted teeth because food particles and bacteria cannot be cleaned out. Other patients also can benefit from sealant placement, such as those who have existing pits and grooves susceptible to decay. Research has shown that almost everybody has a 95-percent chance of eventually experiencing cavities in the pits and grooves of their teeth.
Aren't sealants just for kids?
Decay can begin early in life, so dentists usually apply sealants to children's and teenagers' premolars and molars to protect them. But sealants can protect adults' teeth, too. Ask your dentist about sealants for your children or for yourself to see if they would be beneficial.
Are sealants covered by insurance?
Insurance benefits for sealant procedures have increased considerably, especially as companies start to realize that sealants are a proven preventive technique. This preventive measure can help reduce future dental expenses and protect the teeth from more aggressive forms of treatment.
Updated: February 2007
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com
What are Wisdom Teeth?
Wisdom teeth are the third molars. Normally people have three permanent molars that develop in each quadrant of the mouth; upper, lower, right and left. The first molars usually grow into the mouth at around six years of age. The second molars grow in at around age 12. The third molars usually will try to grow in at around age 17 to 21 years. Since that is considered to be the age when people become wiser, third molars gained the nickname, "wisdom teeth." Actually, they are no different than any other tooth except that they are the last teeth to erupt, or grow into the mouth. They are just as useful as any other tooth if they grow in properly, have a proper bite relationship and have healthy gum tissue around them. Unfortunately, this does not always happen.
Updated: October 2008
What is an Impaction?
When wisdom teeth are prevented from erupting into the mouth properly, they are referred to as impacted. Teeth that have not erupted are not necessarily impacted. It may be that it is still too early in someone's dental development, and if time passes they might grow in properly. A dentist must examine a patient's mouth and his or her X-rays to determine if the teeth are impacted or will not grow in properly. Impacted teeth may cause problems, such as infection, decay of adjacent teeth, gum disease or formation of a cyst (fluid- filled sac) or tumor from the follicle, which is the tissue that formed the crown of the tooth. Many dentists recommend removal of impacted wisdom teeth to prevent potential problems.
Erupted wisdom teeth may also need to be removed. The dentist may recommend this if the tooth is nonfunctional, interfering with the bite, badly decayed, involved with or at risk for periodontal disease, or interfering with restoration of an adjacent tooth. Once again, every case is different, and only your dentist can determine if there is a reason for you to have a tooth removed.
Updated: October 2008
When to Remove Wisdom Teeth
The following symptoms may indicate that the wisdom teeth have erupted and surfaced, and should be removed before they become impacted, in other words, the teeth have surfaced and have no room in the mouth to grow. However, each individual may experience symptoms differently.
Symptoms may include:
- Pain
- Infection in the mouth
- Facial swelling
- Swelling of the gumline in the back of the mouth
Many oral health specialists will recommend removal of the wisdom teeth before they are fully developed, usually in the adolescent years, as early removal will help to eliminate problems, such as an impacted tooth that destroys the second molar.
Wisdom tooth extraction involves accessing the tooth through the soft and hard tissue, gently detaching the connective tissue between the tooth and the bone and removing the tooth. Extractions can be performed under local anesthesia.
Following the extraction, you may experience some swelling and discomfort, which is a normal part of the healing process. Cold compresses can help decrease the swelling, and your dentist may prescribe medication to help relieve discomfort.
Updated: October 2008
Dry Sockets
Dry socket, the most common postoperative complication from tooth extractions, delays the normal healing process and results when the newly formed blood clot in the extraction site does not form correctly or is prematurely lost. The blood clot lays the foundation for new tissue and bone to develop over a two-month healing process. Women who take oral contraceptives are at a higher risk of developing dry socket after wisdom teeth extraction due to high levels of estrogen.
Tips for preventing dry socket:
- Schedule extractions during the last week of the menstrual cycle, when estrogen levels are lower.
- Avoid drinking through a straw, as the suction may interfere with clotting.
- Avoid smoking, which can irritate the extraction site.
- Avoid excessive mouth rinsing, which may interfere with clotting. Updated:
October 2008
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com
What is a Dental Emergency?
Injuries to the mouth may include teeth that are knocked out (avulsed), forced out of position and loosened (extruded) or fractured. In addition, lips, gums or cheeks are often cut. Oral injuries are often painful and should be treated by a dentist as soon as possible.
How soon should I see a dentist?
Immediately. Getting to a dentist within 30 minutes can make the difference between saving or losing a tooth.
What should I do when a tooth is knocked out?
- Immediately call your dentist for an emergency appointment.
- Handle the tooth by the crown, not the root. Touching the root (the part of the tooth below the gum) can damage cells necessary for bone reattachment.
- Gently rinse the tooth in water to remove dirt. Do not scrub.
- If possible, gently place the clean tooth in the socket to keep it moist. It is important not to let the tooth dry out.
- If it is not possible to store the tooth in the mouth of the injured person, wrap the tooth in a clean cloth or gauze and immerse in milk or saliva.
What should I do when a tooth is pushed out of position?
- Attempt to reposition the tooth to its normal alignment using very light finger pressure, but do not force the tooth.
- Bite down to keep the tooth from moving.
What should I do when a tooth is fractured?
- Rinse mouth with warm water.
- Use an ice pack or cold compress to reduce swelling.
- Use ibuprofen, not aspirin, for pain.
- Immediately get to your dentist, who will determine treatment based on how badly the tooth is broken. Only a dentist can tell how bad the break is.
Minor fracture: Minor fractures can be smoothed by your dentist or simply left alone. Another option is to restore the tooth with a composite restoration. In either case, treat the tooth with care for several days.
Moderate fracture: Moderate fractures include damage to the enamel, dentin and/or pulp (nerve and other live tissues). If the pulp is not permanently damaged, the tooth may be restored with a full permanent crown. If damage to the pulp does occur, further dental treatment will be required.
Severe fracture: Severe fractures often mean a traumatized tooth with slim chance of recovery.
What should I do when tissue is injured?
Injuries to the inside of the mouth include tears, puncture wounds and lacerations to the cheek, lips or tongue. The wound should be cleaned right away with warm water, and the injured person taken to a hospital emergency room for the necessary care. Bleeding from a tongue laceration can be reduced by pulling the tongue forward and using gauze to place pressure on the wound.
What can I do to be prepared?
Pack an emergency dental-care kit, including:
- Dentist's phone numbers (home and office)
- Handkerchief
- Gauze Small container with lid
- Ibuprofen (Not aspirin. Aspirin is an anticoagulant, which may cause excessive bleeding in a dental emergency.)
Updated: January 2007
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com
What Causes a Toothache?
While decay often is cited as the primary cause of a toothache, it's important for you to have a complete oral examination to determine the cause. Other dental causes of a toothache include: infection, gum disease, grinding teeth (bruxism), tooth trauma and an abnormal bite. Tooth eruption may be the cause of tooth or jaw pain in babies and school-age children.
TMJ, sinus or ear infections and tension in the facial muscles can cause discomfort that resembles a toothache, but often these health problems are accompanied by a headache. Pain around the teeth and the jaws can be symptoms of heart disease such as angina. If your dentist suspects a medical illness could be the cause of your toothache, he or she may refer you to a physician.
Why does my toothache?
You may have a dental cavity or advanced gum disease. The first sign of decay may be the pain you feel when you eat something sweet, very cold or very hot. If the pulp - the inside of the tooth that has tissue and nerves - has become irritated, this can cause pain in your tooth.
What are the symptoms of a toothache?
Because the symptoms of a toothache may resemble other medical conditions or dental problems, it can be difficult to diagnose the cause without a complete evaluation by your dentist. If you notice pus near the source of the pain, your tooth may have become abscessed, causing the surrounding bone to become infected. Or the pus could indicate gum disease, which usually is characterized by inflammation of the soft tissue and abnormal loss of bone surrounding the teeth.
Contact your dentist immediately if you have any of the following symptoms:
- Fever
- Difficulty breathing or swallowing
- Swelling around the tooth area
- Pain when you bite
- A foul-tasting discharge
How do I alleviate the pain if I cannot see my dentist right away?
Anyone with a toothache should see a dentist at once for diagnosis and treatment because, if left untreated, your condition can worsen. However, if you are unable to schedule an emergency appointment, a self-care treatment can temporarily alleviate pain and inflammation from a toothache:
- Rinse with warm salt water.
- Gently floss teeth to dislodge any food particles trapped between teeth.
- Take an over-the-counter pain reliever such as aspirin, ibuprofen or acetaminophen to relieve pain. If your child has a toothache, use acetaminophen.
- Never put aspirin or any other painkiller against the gums near the aching tooth, as it may burn the gum tissue.
- Apply an over-the-counter antiseptic containing benzocaine directly to the irritated tooth and gum to temporarily relieve pain. Direct application of oil of cloves (eugenol) may also help to numb the gums. The oil may be rubbed directly on the sore area or soak a small piece of cotton and apply it to the sore tooth.
- If there has been some trauma to the tooth, a cold compress may be applied on the outside cheek to relieve pain or swelling. If your tooth has been knocked out, forced out of position, loosened or fractured, visit the dentist's office or a hospital emergency room immediately.
How can my dentist help?
Your dentist will conduct a complete oral examination to determine the location and cause of the toothache, looking for signs of swelling, redness and obvious tooth damage. He or she may also take X-rays looking for evidence of tooth decay between teeth, a cracked or impacted tooth or a disorder of the underlying bone - problems that the dentist may not be able to find through a routine exam.
Your dentist also may prescribe pain medication or antibiotics to speed the healing of your toothache. If, by the time you see your dentist, your tooth has become infected, then treatment could require removal of the tooth or a root canal procedure, which involves removing the damaged nerve tissue from the middle of a tooth.
Is there a way to prevent a toothache?
The key to preventing toothaches is establishing a regular oral hygiene routine and sticking to it. For example, failure to brush and floss regularly after meals can significantly increase your risk of developing cavities. After you eat, bacteria in your mouth feed on sugar and starch and produce acid that can "eat" a hole (or cavity) in your tooth's enamel. If the cavity is not filled, it can cause considerable pain and potentially destroy the dentin, pulp and the tooth's nerve.
Here are a few tips to help reduce your risk for developing a toothache:
- Brush at least twice a day, preferably after every meal and snack.
- Floss once a day to prevent gum disease.
- Visit your dentist twice a year for oral examinations and a professional cleaning.
Updated: February 2007
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com
What is Tooth Decay?
Tooth decay, also known as caries or cavities, is an oral disease that affects many people. Unlike other diseases, however, caries is not life-threatening and is highly preventable, though it affects most people to some degree during their lifetime.
Natural bacteria live in your mouth and form plaque. The plaque interacts with deposits left on your teeth from sugary and starchy foods and produces acids. These acids damage tooth enamel over time by dissolving, or demineralizing enamel, which weakens the teeth and leads to tooth decay.
Foods containing carbohydrates (starches and sugars), such as soda pop, candy, ice cream, milk, and cake, and even some fruits, vegetables, and juices, may contribute to tooth decay.
Updated: February 2007
How Are Cavities Prevented?
The acids formed by plaque can be counteracted simply by saliva in your mouth, which acts as a buffer and remineralizing agent. Dentists often recommend chewing sugarless gum to stimulate your flow of saliva. However, though it is the body's natural defense against cavities, saliva alone is not sufficient to combat tooth decay. The best way to prevent cavities is to brush and floss regularly. To rebuild the early damage caused by plaque bacteria, we use fluoride, a natural substance that helps to remineralize the tooth structure. Fluoride is added to toothpaste to fight cavities. The most common source of fluoride is in the water we drink. Fluoride is added to most community water supplies and to many bottled and canned beverages.
If you are at medium-to-high-risk for cavities, your dentist may recommend special high-concentration fluoride gels, mouth rinses or dietary fluoride supplements. Your dentist may also use professional strength anti-cavity varnish, or sealants - thin, plastic coatings that provide an extra barrier against food and debris.
Updated: October 2008
Who Is At Risk For Cavities?
Because we all carry bacteria in our mouths, everyone is at risk for cavities. Those with a diet high in carbohydrates and sugary foods and those who live in communities without fluoridated water are likely candidates for cavities. And because the area around a restored portion of a tooth is a good breeding ground for bacteria, those with a lot of fillings have a higher chance of developing tooth decay. Children and senior citizens are the two groups at highest risk for cavities.
Updated: October 2008
Three Ways To Prevent Cavities
- Cut down on sweets and between-meal snacks. Remember, it's these sugary and starchy treats that put your teeth at extra risk. Some research says certain foods, such as peanuts or sugar-free chewing gum, may be "friendly" to teeth. Eating these foods along with or after foods that contain carbohydrates may help to counter the effects of acids produced by bacteria. Drinking plenty of water can help wash away food particles. Of course, dentists encourage their patients to eschew these sugary snacks in favor of healthy alternatives.
- Brush after every meal and floss daily. Cavities most often begin in hard-to-clean areas between teeth and in the fissures and pits - the edges in the tooth crown and gaps between teeth. Hold the toothbrush at a 45-degree angle and brush inside, outside and between your teeth and on the top of your tongue. Be sure the bristles are firm, not bent, and replace the toothbrush after a few weeks to safeguard against re-infecting your mouth with old bacteria than can collect on the brush. Only buy toothpastes and rinses that contain fluoride (antiseptic rinses also help remove plaque) and that bear the American Dental Association seal on the package. Children under age 6 should only use a small pea-sized dab of toothpaste on the brush and should spit out as much as possible, because a child's developing teeth are sensitive to higher fluoride levels. Finally, because caries is a transmittable disease, toothbrushes should never be shared, especially with your children.
- See your dentist at least every six months for checkups and professional cleanings. Because cavities can be difficult to detect, a thorough dental examination is very important. If you get a painful toothache, if your teeth are very sensitive to hot or cold foods or if you notice signs of decay like white spots, tooth discolorations or cavities, make an appointment right away. The longer you wait to treat infected teeth, the more intensive and lengthy the treatment will be. Left neglected, cavities can lead to root canal infection, permanent deterioration of decayed tooth substance and even loss of the tooth itself.
Updated: October 2008
© 1996-2011 Academy of General Dentistry. All Rights Reserved.
www.knowyourteeth.com