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Posts for category: Oral Health

By Oral & Maxillofacial Surgery of the Lowcountry
May 22, 2020
Category: Oral Health
YouDontNeedtoPassaFootballLikePatrickMahomestoRemoveaLooseBabyTooth

Kids get pretty inventive pulling a loose primary (baby) tooth. After all, there's a profit motive involved (aka the Tooth Fairy). But a young Kansas City Chiefs fan may have topped his peers with his method, revealed in a recent Twitter video that went viral.

Inspired by all-star KC quarterback Patrick Mahomes (and sporting his #15 jersey), 7-year-old Jensen Palmer tied his loose tooth to a football with a line of string. Then, announcing “This is how an MVP gets their tooth out,” the next-gen QB sent the ball flying, with the tooth tailing close behind.

It appears young Palmer was no worse for wear with his tooth removal technique. But if you're thinking there might be a less risky, and less dramatic, way to remove a loose tooth, you're right. The first thing you should know, though: Primary teeth come out when they're good and ready, and that's important. Primary teeth play an important role in a child's current dental and speech function and their future dental development. For the latter, they serve as placeholders for permanent teeth developing within the gums. If one is lost prematurely, the corresponding permanent tooth might erupt out of position and cause bite problems.

In normal development, though, a primary tooth coming out coincides closely with the linked permanent tooth coming in. When it's time, the primary tooth lets you know by becoming quite loose in the socket.

If you think one of your children's primary teeth is ready, clean your hands first with soap and water. Then using a clean tissue, you should be able to easily wiggle the tooth with little tension. Grasp the tooth with the tissue and give it a little horizontal twist to pop it out. If that doesn't work, wait a day or two before trying again. If it does come out, be sure you have some clean gauze handy in case of bleeding from the empty socket.

Normally, nature takes its course from this point. But be on the lookout for abnormal signs like fragments of the tooth left behind in the socket (not to be mistaken for the top of the permanent tooth coming in). You should also look for redness, swelling or complaints of pain the following day—signs of possible infection. If you see anything like this, make a prompt appointment so we can take a look. Losing a primary tooth is a signpost pointing the way from childhood to adulthood (not to mention a windfall for kids under their pillows). You can help make it a smooth transition—no forward pass required.

If you would like more information about caring for primary teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Importance of Baby Teeth” and “Losing a Baby Tooth.”

By Oral & Maxillofacial Surgery of the Lowcountry
April 12, 2020
Category: Oral Health
DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”

By Oral & Maxillofacial Surgery of the Lowcountry
March 13, 2020
Category: Oral Health
Tags: tmj disorders  
WhytheTreatmentModelforYourJawJointDisorderMatters

Your temporomandibular joints (TMJ), located where your lower jaw meets the skull, play an essential role in nearly every mouth function. It’s nearly impossible to eat or speak without them.

Likewise, jaw joint disorders (temporomandibular joint disorders or TMD) can make your life miserable. Not only can you experience extreme discomfort or pain, your ability to eat certain foods or speak clearly could be impaired.

But don’t assume you have TMD if you have these and other symptoms — there are other conditions with similar symptoms. You’ll need a definitive diagnosis of TMD from a qualified physician or dentist, particularly one who’s completed post-graduate programs in Oral Medicine or Orofacial Pain, before considering treatment.

If you are diagnosed with TMD, you may then face treatment choices that emanate from one of two models: one is an older dental model based on theories that the joint and muscle dysfunction is mainly caused by poor bites or other dental problems. This model encourages treatments like orthodontically moving teeth, crowning problem teeth or adjusting bites by grinding down tooth surfaces.

A newer treatment model, though, has supplanted this older one and is now practiced by the majority of dentists. This is a medical model that views TMJs like any other joint in the body, and thus subject to the same sort of orthopedic problems found elsewhere: sore muscles, inflamed joints, strained tendons and ligaments, and disk problems. Treatments tend to be less invasive or irreversible than those from the dental model.

The newer model encourages treatments like physical therapy, medication, occlusive guards or stress management. The American Association of Dental Research (AADR) in fact recommends that TMD patients begin their treatment from the medical model rather than the dental one, unless there are indications to the contrary. Many studies have concluded that a majority of patients gain significant relief with these types of therapies.

If a physician or dentist recommends more invasive treatment, particularly surgery, consider seeking a second opinion. Unlike the therapies mentioned above, surgical treatments have a spotty record when it comes to effectiveness — some patients even report their conditions worsening afterward. Try the less-invasive approach first — you may find improvement in your symptoms and quality of life.

If you would like more information on treating TMD, 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 “Seeking Relief from TMD.”

By Oral & Maxillofacial Surgery of the Lowcountry
March 03, 2020
Category: Oral Health
CustomMouthguardsArentJustforNFLSuperstars

If while watching a Seattle Seahawks game you thought you saw wide receiver D. K. Metcalf sucking on a “binky,” your eyes weren’t deceiving you. Well, sort of not—he’s actually been known to wear a mouth and lip guard shaped like a child’s pacifier.

Metcalf isn’t the only pro football player customizing this essential piece of safety equipment. Broncos running back Ronnie Hillman has been seen sporting “vampire fangs.” And Odell Beckham Jr., wide receiver with the Cleveland Browns, has a series of interchangeable guards with various designs and colors.

You may say, “That’s the NFL, so of course players have the money and fame to dress up their mouthguards with a little flair.” But custom mouthguards aren’t out of reach for the average athlete—in fact, it’s actually a sound idea. Not so much for expressing personality, but for the comfort and protective advantages that a custom mouthguard may have over retail varieties.

Usually made of high-resistant plastic, an athletic mouthguard absorbs blows to the face and mouth during hard contacts in sports like football, basketball and hockey. Mandated by many organized sports associations, mouthguards can prevent dental and facial injuries like chipped or knocked out teeth, gum abrasions or jaw fractures. There’s even some evidence they reduce the risk of concussion.

Many amateur players use what is known as a “boil and bite” mouthguard, available in retail sporting goods stores. They’re softened first, usually in hot water, and then placed in the mouth and clenched between the jaws to obtain a somewhat individualized fit.

Although they do provide some level of protection, a boil and bite mouthguard can’t match the accuracy of a custom mouthguard produced by a dentist based on impressions and measurements of an individual player’s mouth. As a result, custom mouthguards can be made thinner than many boil and bite guards, increasing their comfort while being worn. More importantly, their accurate fit enhances their protective capabilities.

As you might imagine, custom mouthguards are more expensive than their retail counterparts, and with younger athletes whose mouth structures are still growing, it may be necessary to upgrade a custom guard after a few seasons. Still, the cost of a custom mouthguard may be well worth the superior protection it provides for your own little star athlete. And although it may not necessarily look like a binky or vampire fangs, a custom mouthguard could make their playing experience safer and more comfortable.

If you would like more information about custom athletic mouthguards, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Athletic Mouthguards.”

By Oral & Maxillofacial Surgery of the Lowcountry
February 22, 2020
Category: Oral Health
SevereFacePaincanbeManagedtoReduceDiscomfort

Recurring episodes of severe pain along your face could mean you have trigeminal neuralgia (TN). Although not always curable, TN can be managed effectively with the right strategy.

TN affects a specific pair of nerves called the trigeminal that signal pain in the face or jaws. They originate from the brain stem through the skull on either side of the face, with each nerve having upper, middle and lower branches. TN can affect one or more of these branches and cause anywhere from a mild twinge to excruciating pain.

Causes for TN differ in individual patients. Though it could be linked to a tumor, lesion or cold sore, it most often seems to arise from a blood vessel impinging on the nerve and damaging its outer coating. This causes it to be hypersensitive: chewing, speaking or even lightly touching the face can set it off. The damaged nerve may also fail to "shut off" when the triggering stimulation stops.

If you have these types of symptoms, your first step is to obtain an accurate diagnosis. You'll need a thorough examination to rule out other possibilities like jaw joint problems or a tooth abscess. Once we've determined it's definitely TN, we can then devise a treatment strategy.

We usually begin with conservative measures like medication to block pain transmission to the brain or anticonvulsants that stabilize the nerve and decrease abnormal firing. If medication isn't enough, we may then consider an invasive procedure to control symptoms.

Percutaneous treatment — often recommended for older patients or those in poor health — involves inserting a thin needle into the nerve to selectively damage certain fibers that will prevent the nerve from signaling pain. We might be able to move an impinging blood vessel aside from the nerve with a microsurgical procedure. As an alternative to surgery, high-dose radiation could also be aimed precisely at the pain site with a controlled beam to alter the nerve's ability to transmit pain.

TN can be a source of great discomfort that lowers your quality of life. But employing treatment techniques that best suit your situation, we can greatly reduce the misery it inflicts.

If you would like more information on facial pain caused by trigeminal neuralgia, 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 “Trigeminal Neuralgia: A Nerve Disorder that Causes Facial Pain.”