By Randall J. Bartoe, DDS, PLC
December 28, 2018
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 Randall J. Bartoe, DDS, PLC
December 18, 2018
Category: Oral Health
5WarningSignsYouMayHaveGumDisease

Periodontal (gum) disease, a bacterial infection caused by plaque, is one of the most prevalent and destructive dental conditions. Left untreated it can eventually lead to tooth and bone loss.

Although people are often unaware they have gum disease, there are a few warning signs to look for. Here are five gum disease signs that should prompt a dental visit.

Gum Swelling and Redness. Like all infections, gum disease triggers an immune system response that releases antibodies into the gums to attack the bacteria. The ensuing battle results in inflammation (swelling) and a darker redness to the gum tissues that don’t lessen with time.

Gum Bleeding. It isn’t normal for healthy gum tissue, which are quite resilient, to bleed. In a few cases, bleeding may indicate over-aggressive brushing, but more likely it means the tissues have weakened to such an extent by infection they bleed easily.

Tooth Sensitivity. If you notice a shot of pain when you eat or drink something hot or cold or when you bite down, this could mean infected gums have “drawn back” (receded) from the teeth. Gum recession exposes the tooth roots, which are more sensitive to temperature and pressure changes in the mouth.

An Abscess. As weakened gum tissues detach from the tooth, the normally thin gap between them and the tooth deepens to form a void known as a periodontal pocket. This often results in an abscess where pus collects in the pocket and causes it to appear more swollen and red than nearby tissues. An abscess needs immediate attention as bone loss is greatly accelerated compared to normal gum disease.

Tooth Looseness or Movement. As diseased gum tissue causes loss of gum and bone attachment, the affected teeth will start to feel loose or even move to a different position. This is a late and alarming sign of gum disease — without immediate intervention, you’re in danger of losing the tooth.

If you encounter any of these signs, contact us for an examination as soon as possible. The sooner we can diagnose gum disease and begin treatment, the less damage it will cause — and the better your odds of regaining healthy teeth and gums.

If you would like more information on gum disease, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Warning Signs of Periodontal (Gum) Disease.”

By Randall J. Bartoe, DDS, PLC
December 08, 2018
Category: Oral Health
Tags: tooth decay  
WillieWonkasChocolateFactoryWasNotSoSweettoCastsTeeth

The classic movie Willie Wonka & the Chocolate Factory, starring Gene Wilder, still brings back sweet memories of childhood to people everywhere. Recently, the news broke that a remake of the beloved 1971 film is in now development in Hollywood. But at a reunion of the original cast members a few years ago, child star Denise Nickerson revealed that her role as gum-chewing Violet Beauregard caused a problem: she ended up with 13 cavities as a result of having to chew gum constantly during the filming!

It should come as no surprise that indulging in sugary treats can lead to cavities: The sugar in your diet feeds harmful bacteria that can cause tooth decay and other dental problems. Yet lots of kids (not to mention the child inside many adults) still crave the satisfaction that gum, candy and other sweets can bring. Is there any way to enjoy sweet treats and minimize the consequences to your oral health?

First, let’s point out that there are lots of healthy alternatives to sugary snacks. Fresh vegetables, fruits and cheeses are delicious options that are far healthier for you and your kids. Presenting a variety of appealing choices—like colorful cut-up carrots, bite-sized cheese bits and luscious-looking fruits and berries can make it easier (and more fun) to eat healthy foods. And getting kids off the sugar habit is a great way to help them avoid many health problems in the future.

For those who enjoy chewing gum, sugarless gum is a good option. In fact, chewing sugarless gum increases the flow of healthful saliva in the mouth, which can help neutralize the bacteria-produced acids that cause cavities. Gums that have the ADA (American Dental Association) Seal of Acceptance have passed clinical tests for safety and effectiveness.

But if you do allow sugary snacks, there are still a few ways to minimize the potential damage. Restrict the consumption of sweets to around mealtimes, so the mouth isn’t constantly inundated with sugar. Drink plenty of water to encourage saliva flow, and avoid sugary and acidic beverages like soda (even diet soda) and “sports” or “energy” drinks. Brush twice daily with fluoride toothpaste and floss once a day. And don’t forget to visit our office regularly for routine checkups and cleanings. It’s the best way to get a “golden ticket” to good oral health.

If you would like more information about sugar, cavities and oral health, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Nutrition & Oral Health” and “The Bitter Truth About Sugar.”

By Randall J. Bartoe, DDS, PLC
November 28, 2018
Category: Dental Procedures
Tags: dental implants  
ConsiderBoneHealthWhenDecidingBetweenImplantsandDentures

Losing permanent teeth is never good — unlike primary teeth, no natural replacements wait in the wings. But the good news is you have a number of options for replacing them with life-like prosthetic (false) teeth.

Today's premier choice is dental implants, preferred by dentists and patients alike for their durability and life-likeness. But because of their cost when replacing multiple teeth, many people opt for traditional dentures. And now dentures are easier to wear and maintain thanks to new, advanced materials and designs.

Still, there's one major area where implants have the definite edge over dentures — long-term bone health. Older bone cells die and dissolve (resorb), replaced then by newly formed cells. Teeth help perpetuate this cycle through the forces generated when we chew that travel through the roots to stimulate the formation of new bone.

But because this stimulation through a tooth ends when it's lost, new bone beneath the empty socket may not keep up with the resorption rate of older bone. As a result, you could lose as much as a quarter of normal bone width in just the first year after losing a tooth.

This bone loss will continue to accumulate even if you wear dentures, which can't replicate the bone growth stimulation of natural teeth. What's more, the constant pressure on the bony ridge of the gums can accelerate bone loss. Eventually, the firm, comfortable fit you first had with your dentures will become looser and less comfortable with the shrinking bone volume.

Implants, on the other hand, can stop bone loss and may even reverse it. This is because the titanium metal of an implant has a special affinity with bone cells that readily grow and adhere to it. This creates the anchorage responsible for the implant's durability, but it's also healthy for the bone.

Of course, this doesn't have to be a binary choice between the two restorations thanks to a new hybrid advancement that combines implants with dentures. We can install as few as two implants to support a removable denture. You'll enjoy greater stability, fit and durability with your dentures, while also improving bone health through the implants.

So before you decide on a dental restoration, be sure to discuss with us your implant options. Your oral health and appearance could benefit immensely.

If you would like more information on dental restoration, 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 “The Hidden Consequences of Losing Teeth.”

By Randall J. Bartoe, DDS, PLC
November 18, 2018
Category: Oral Health
Tags: celebrity smiles   retainer  
FanofSuperheroFilmBlackPantherBreaksSteelWirewithHerMouth

Some moviegoers have been known to crunch popcorn, bite their fingers or grab their neighbor’s hands during the intense scenes of a thriller. But for one fan, the on-screen action in the new superhero film Black Panther led to a different reaction.

Sophia Robb, an 18-year-old Californian, had to make an emergency visit to the orthodontic office because she snapped the steel wire on her retainer while watching a battle scene featuring her Hollywood crush, Michael B. Jordan. Her jaw-clenching mishap went viral and even prompted an unexpected reply from the actor himself!

Meanwhile, Sophia got her retainer fixed pronto—which was exactly the right thing to do. The retention phase is a very important part of orthodontic treatment: If you don’t wear a retainer, the beautiful new smile you’re enjoying could become crooked again. That’s because if the teeth are not held in their new positions, they will naturally begin to drift back into their former locations—and you may have to start treatment all over again…

While it’s much more common to lose a removable retainer than to damage one, it is possible for even sturdy retainers to wear out or break. This includes traditional plastic-and-wire types (also called Hawley retainers), clear plastic retainers that are molded to fit your teeth (sometimes called Essix retainers), and bonded retainers: the kind that consists of a wire that’s permanently attached to the back side of your teeth. So whichever kind you use, do what Sophia did if you feel that anything is amiss—have it looked at right away!

When Black Panther co-star Michael B. Jordan heard about the retainer mishap, he sent a message to the teen: “Since I feel partly responsible for breaking your retainers let me know if I can replace them.” His young fan was grateful for the offer—but even more thrilled to have a celebrity twitter follower.

If you have questions about orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Bonded Retainers.”





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