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By Zsambeky, Chaney & Associates Family Dentistry
February 12, 2020
Category: Oral Health
Tags: dental injuries  
TakeTheseStepstoSaveaKnocked-OutTooth

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.”

By Zsambeky, Chaney & Associates Family Dentistry
February 02, 2020
Category: Oral Health
Tags: oral health  
4SupposedHealthDangersinDentalCareThatArentDangerous

Holistic medicine aims to provide healthcare for the “whole” person. While it's a worthy approach, the term has also been used to advance ideas, including in dentistry, at odds with solid scientific evidence.

Here are 4 “holistic” oral health claims and why you should be wary of them.

Root canals are dangerous. It might be shocking to learn that some claim this routine tooth-saving procedure increases the risk of disease. The claim comes from an early 20th Century belief that leaving a “dead” organ like a root-canaled tooth in the body damages the immune system. The idea, though, has been thoroughly disproved, most recently by a 2013 oral cancer study that found not only no evidence of increased cancer, but an actual decrease in cancer risk following root canal treatment.

X-rays are hazardous. X-rays have improved tooth decay treatment by allowing dentists to detect it at earlier stages. Even so, many advise avoiding X-rays because, as a form of radiation, high levels could damage health. But dentists take great care when x-raying patients, performing them only as needed and at the lowest possible exposure. In fact, people receive less radiation through dental X-rays than from their normal background environment.

Silver fillings are toxic. Known for their strength and stability, dentists have used silver fillings for generations. But now many people are leery of them because it includes mercury, which has been linked to several health problems. Research concludes that there's no cause for alarm, or any need to remove existing fillings: The type of mercury used in amalgam is different from the toxic kind and doesn't pose a health danger.

Fluoride contributes to disease. Nothing has been more beneficial in dental care or more controversial than fluoride. A proven weapon against tooth decay, fluoride has nonetheless been associated with ailments like cancer or Alzheimer's disease. But numerous studies have failed to find any substantial disease link with fluoride except fluorosis, heavy tooth staining due to excess fluoride. Fluorosis, though, doesn't harm the teeth otherwise and is easily prevented by keeping fluoride consumption within acceptable limits.

Each of these supposed “dangers” plays a prominent role in preventing or minimizing dental disease. If you have a concern, please talk with your dentist to get the true facts about them.

If you would like more information on best dental practices, 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 “Holistic Dentistry: Fads vs. Evidence-Based Practices.”

By Zsambeky, Chaney & Associates Family Dentistry
January 23, 2020
Category: Dental Procedures
TheRealTruthBehindEdHelmsMissingToothinTheHangover

Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.

In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.

Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.

Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.

If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.

The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.

Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.

If you would like more information about restoring missing teeth, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Dental Implants.”

By Zsambeky, Chaney & Associates Family Dentistry
January 13, 2020
Category: Oral Health
Tags: pain management  
IsThereaBetterWaytoManagePainWithoutNarcotics

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.

If you would like more information on pain management practices in dental care, please contact us or schedule an appointment for a consultation.

By Zsambeky, Chaney & Associates Family Dentistry
January 03, 2020
Category: Dental Procedures
StopBiteProblemsEarlyWithInterceptiveOrthodontics

Every year many parents learn their “tweenager” or teenager needs their bite corrected, often with specialized orthodontics. Imagine, though, if these families could go back in time to when their child’s poor bite was just developing to stop or slow it from forming.

Time travel may still be science fiction, but the approach suggested isn’t. It’s called interceptive orthodontics, a group of techniques and procedures performed during the early stages of jaw development. The focus is usually on getting abnormal jaw growth back on track, enough so that a poor bite won’t form.

The upper jaw, for example, may be growing too narrow, reducing the amount of available space for tooth eruption. If it isn’t corrected, teeth can erupt out of position. To correct it, an orthodontist places a palatal expander in the roof of the child’s mouth (palate). The appliance applies gentle pressure against the inside of the teeth, which stimulates the jaws to develop wider.

The expander works because of a separation in the bones at the center of the palate, which later fuse around puberty. The pressure applied from the expander keeps this gap slightly open; the body then continues to fill the widening expansion with bone, enough over time to widen the jaw. If you wait until puberty, the gap has already fused, and it would have to be reopened surgically to use this technique. Ideally, then, a palatal expander should be employed at a young age.

Not all interceptive techniques are this extensive—some, like a space maintainer, are quite simple. If a primary (baby) tooth is lost prematurely, teeth next to the empty space tend to drift into it and cause the intended permanent tooth to erupt out of place due to a lack of space. To prevent this an orthodontist places a small wire loop within the space to prevent other teeth from moving into it.

These are but two examples of the many methods for stopping or slowing a developing bite problem. To achieve the best outcome, they need to be well-timed. Be sure, then, to have your child undergo an orthodontic evaluation around age 6. If an interceptive orthodontic approach is needed, it could eliminate the need for more extensive—and expensive—treatment later.

If you would like more information on treatments to get ahead of bite problems, please contact us or schedule an appointment for a consultation.





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