We’re used to seeing athletes wearing mouthguards at practice or play, because dental trauma is one of the most common (and predictable) sports injuries. But it’s not just athletes who are at risk, and there are some events in our daily lives that we just can’t predict. Car accidents, falls, workplace injuries, even innocent playground structures can take their toll on our smiles.

A major chip or a crack in your tooth is upsetting enough, and should be seen by a dentist as soon as possible. It’s even more unnerving when a tooth is knocked out completely. The technical term for a tooth which has been knocked out is an avulsed tooth, and it is a true dental emergency.

If you should suffer a partially or completely dislodged tooth, there is a possibility that your tooth can be reimplanted—if the damage isn’t too severe and if you get to your oral surgeon or dentist immediately.

How can a lost tooth be saved? This is possible because of the complex biological engineering that anchors our teeth within the jaw. The root of a tooth is surrounded by the periodontal ligament. This connective tissue attaches the tooth to the alveolar bone of the jaw. When a tooth is knocked out, this ligament splits apart, leaving some tissue on the tooth root and some within the tooth’s socket.

To successfully reimplant a tooth, the connective tissue cells around the root of the tooth need to be vital, so that they can begin to reattach to the connective tissue left in the socket. Over time, this reattachment is complete, and the tooth becomes firmly anchored to the bone again.

It’s important to protect your tooth before you see us to make sure there will be enough healthy tissue for reattachment. First of all,

• Don’t panic! If you or a friend or family member lose a tooth, call your oral surgeon, your dentist, or your emergency health care provider as soon as possible. You will get specific instructions for your specific situation.

If you are unable to reach your health care provider immediately, there are some general rules for taking care of an avulsed tooth:

• Find the lost tooth. Don’t touch the root—use the crown, or top part of the tooth, to pick it up. You are trying to preserve and protect the connective tissue on the root surface.

• If the tooth is dirty, gently rinse it in milk, saliva, or water. Don’t wipe it off, though. You could damage those connective tissue cells mentioned above.

• Place the tooth back in the socket, if possible. Gently hold it in place with your fingers or bite down (again, gently). You can also place the tooth in your mouth next to your cheek.

• If returning the tooth to the socket is not an option, or if you are worried about a child possibly swallowing the tooth, keep the tooth moist. Whole milk or solutions sold just for the purpose of preserving an avulsed tooth are better choices than water, which damage the tissue cells on the root. And never wrap the tooth tightly—this can also damage the connective tissue.

Above all,

• Don’t delay! The faster a tooth is reimplanted in its socket, the greater chance you have of keeping it. Really, every minute counts. Reimplantations are more successful if they take place within 30 minutes. After an hour out of the mouth, your tooth’s chances of successful reintegration are lower—but still worth pursuing!

What will your oral surgeon do?

• Evaluate the avulsed tooth.

There are variables which can affect whether or not a lost tooth is a good candidate for reimplantation. Trying to replace a baby tooth, for example, could interfere with the formation of the adult tooth. An adult tooth that is broken will probably require a different type of treatment.

• Prevent infection.

You might be given antibiotics and a referral to your doctor for a tetanus booster if needed.

• Clean the site.

The socket will be gently irrigated to clean the area and to remove any clots that may have formed which can interfere with the tooth’s placement.

• Recommend or perform a root canal.

Nerves and blood vessels within the tooth’s pulp generally don’t recover after a serious traumatic injury, so a root canal procedure could be necessary to preserve the health of your tooth. This procedure might be done immediately, or might be recommended for a later date.

• Stabilize your tooth.

The tooth must be stabilized after being reimplanted, so Dr. Jenny Kanganis will use a splint to anchor the tooth to the teeth next to it. The splint can be flexible or rigid, depending on the condition of the alveolar bone. Splinting generally takes from two to eight weeks, and you will be given detailed instructions for taking care of the area while you heal.

Whether it’s a broken tooth or injured gums, a dental emergency can interfere with eating, speaking, or other day-to-day activities. According to the American Dental Association , you can sometimes prevent dental emergencies like these by avoiding the use of your teeth as tools or by giving up hard foods and candies.

Even if you take excellent care of your mouth, however, unexpected dental problems can still arise. Our team at Bronxville Dental Care is available 24 hours a day, seven days a week to assess and resolve your individual situation. When an emergency arises, you should immediately make an appointment with our office so we can put you at ease, give you the best possible care, and help you return quickly to your regular routine.

Damaged Teeth

For tooth damage in particular, don’t hesitate to call and schedule an emergency dental appointment. You should come in as soon as possible. However, if you have some time before your appointment there are a few things you can do to avoid further injury. If you break your tooth, clean the area well by rinsing it with warm water. To ease any discomfort, put a cold compress against your skin near the area with the affected tooth.

Injured Soft Tissues

For other problems, such as bleeding gums or an injured tongue, cheek, or lip, we recommends gently rinsing your mouth with salt water. If you’re also experiencing some discomfort, you can put a cold compress on your cheek near the area of the bleeding. If the bleeding continues, don’t hesitate to contact our office so you can receive further help.

A dental emergency may catch you off guard, but Dr. Jenny A. Kanganis can provide fast, pain-free treatment. Follow the advice above and set up an appointment with us as soon as possible so you can put your teeth and mouth on the road to recovery.

Cancer has become a common word, and it seems like there is new research about it every day. We know antioxidants are important. We know some cancers are more treatable than others. We know some lifestyles and habits contribute to our cancer risk.

Smoking increases our risk of cancer, as does walking through a radioactive power plant. But there is a direct link to oral cancer that you many may not know about—the link between HPV (Human Papilloma Virus) and oral cancer.

This may come as a shock because it has been almost a taboo subject for some time. A person with HPV is at an extremely high risk of developing oral cancer. In fact, smoking is now second to HPV in causing oral cancer!

According to the Oral Cancer Foundation, “The human papilloma virus, particularly version 16, has now been shown to be sexually transmitted between partners, and is conclusively implicated in the increasing incidence of young non-smoking oral cancer patients. This is the same virus that is the causative agent, along with other versions of the virus, in more than 90% of all cervical cancers. It is the foundation’s belief, based on recent revelations in peer reviewed published data in the last few years, that in people under the age of 50, HPV16 may even be replacing tobacco as the primary causative agent in the initiation of the disease process.” [http://www.oralcancerfoundation.org/facts/]

There is a test and a vaccine for HPV; please discuss it with your physician.

There are some devices that help detect oral cancer in its earliest forms. We all know that the survival rate for someone with cancer depends greatly on what stage the cancer is diagnosed. Talk to Dr. Jenny A. Kanganis if you have any concerns.

Please be aware and remember that when it comes to your own health, knowledge is power. When you have the knowledge to make an informed decision, you can make positive changes in your life. The mouth is an entry point for your body. Care for your mouth and it will care for you!

by Jenny A. Kanganis, D.D.S.

Bronxville Dental Care

Have you ever walked down the oral hygiene aisle overwhelmed by all of the choices of toothpastes, toothbrushes, and floss? Add all the countless varieties of mouthwashes, and it’s enough to make your head spin! Should you be using a daily mouthwash; and if so, which one? We thought we would try to simplify things a bit so that you can make the best choice for you and for your family.

First off, should you even consider using a mouthwash if you are brushing and flossing? The answer depends on your current oral condition and healthcare needs.  Almost all adults, teens, and children over the age of six can benefit from the use of a daily mouthwash as an aid to improving their oral health. Using a mouthwash however, is not a substitute for brushing or flossing; but rather, it is one more tool in your oral healthcare prevention toolbox.

Let’s start with the two general categories of mouthwash: cosmetic and therapeutic. As the name implies, cosmetic mouthwashes are considered to be temporary solutions as they don’t contain any ingredients that will chemically or biologically control or prevent disease. For example, a cosmetic mouthwash may control bad breath for a short time by making the mouth taste and feel fresh, but it won’t actually control or kill the bacteria which cause the bad breath. Another type of cosmetic mouthwash may help to temporarily whiten stains on teeth without actually bleaching the teeth. In contrast, a therapeutic mouthwash contains active ingredients (such as alcohol, fluoride, peroxide and essential oils) which can help control oral diseases and conditions like gingivitis, halitosis, cavities and dry mouth by targeting the bacteria responsible for these harmful conditions.  Most therapeutic mouthwashes can be found over-the-counter, although there are several that can be obtained by prescription only from your dentist.

If you suffer from gingivitis, then a mouthwash specifically formulated for that condition would be most appropriate. Children and adults alike who live in areas without fluoridated water, or who drink filtered water that removes the fluoride ion, and those who suffer from an increased risk of cavities due to poor nutrition or oral hygiene would benefit from using a daily fluoride rinse. If you suffer from dry mouth, then look for a mouthwash that is free from alcohol, as alcohol can further dry the mouth.  In addition, dry mouth also poses an increased risk of cavities, so using one mouthwash that targets both conditions is ideal. There are even mouthwashes that help to clean and to heal mouth sores.

When looking for the appropriate mouthwash, always make sure that it has the Seal of Acceptance form the American Dental Association.  This seal means that the claims on the label have been tested and are accurate, and that the ingredients are safe and effective. There are also a few all-natural brands that have earned this seal, as well. And remember, it is always best to check with your own dentist to see which mouthwash is best for you!