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Dr. Karen Lawitts and Dr. Nancy Yeates

100 Intrepid Lane
Syracuse, NY 13205

(315) 492-8138
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Syracuse, NY 13205

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Posts for tag: dental injury

AChildsDamagedToothmayrequireaDifferentApproachthananAdults

A traditional root canal procedure can be a “life-saver” for a decayed or injured tooth. But while it’s usually the best course for a damaged adult tooth, variations of the procedure are advisable for a new permanent tooth in a child or young adolescent.

This is because the inner pulp, the focus of the treatment, plays an important role in a young tooth’s development. When it first erupts a tooth’s dentin layer, the living tissue that makes up most of the body and roots of the tooth, hasn’t fully formed. The pulp increases the dentin layer over time in conjunction with jaw development.

Because a full root canal treatment removes all of the pulp tissue, it could interrupt any remaining dentin development in a young tooth. This could lead to poorly-formed roots and a less healthy tooth. For an immature permanent tooth, then, we would use variations of a root canal treatment depending on the nature and extent of the injury, the patient’s overall health and medications they may be taking.

Our main objective is to expose or remove as little of the pulp tissue as possible when treating the tooth. If the pulp hasn’t been exposed by the decay or injury, we may only need to remove the softened decayed or injured dentin while leaving harder dentin nearer the pulp intact. If, however, the pulp has become partially exposed by disease or injury, we would then perform a pulpotomy in which we remove only the exposed tissue and then place calcium hydroxide or mineral trioxide aggregate (MTA) to stimulate dentin growth that will eventually patch the exposure site.

In cases where decay or injury has rendered an immature tooth’s pulp tissue unsalvageable, we may use a procedure known as apexification that seals off the open, cylindrical root end of the tooth. This will allow bone-like tissue to grow around the root to serve as added support for the tooth. Although it can save a tooth in the short run, the tooth’s long-term survival chances may be lower.

By using these and other techniques we may be able to save your child’s immature tooth. At the very least, such a technique could postpone replacing the tooth until a more opportune time in adulthood.

If you would like more information on treating damaged teeth in children, 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 “Saving New Permanent Teeth after Injury.”

By Drs Lawitts and Yeates
November 19, 2014
Category: Oral Health
Tags: dental injury   mouthguards  
MouthguardsFoundtobeEffectiveinPreventingTeethandMouthInjuries

Athletes in contact sports are at significant risk for traumatic injury to their teeth and mouth. It’s estimated 600,000 emergency room visits each year involve a sports-related dental injury.

Athletic mouthguards have become the premier safeguard against sports-related oral injuries. First worn by professional boxers in the 1920s, mouthguards are now required for use by various sports associations and leagues — from amateur youth to professional — for a number of sports. The National Collegiate Athletic Association (NCAA), for example, requires their use during play for hockey, lacrosse, field hockey and football. The American Dental Association recommends mouthguards for 29 sports or exercise activities.

But do mouthguards actually prevent injury? To answer that question in a scientific manner, the Journal of Sports Medicine published an evidence-based report in 2007 on mouthguard effectiveness for preventing or reducing the severity of oral-facial injuries and concussions. While the report objectively analyzed many of the problems and issues associated with mouthguards (like materials, design and durability), it concluded the risk of an oral-facial injury was nearly two times greater without the wearing of a mouthguard.

That being said, most dentists and other professionals in sports safety would advise not all mouthguards are alike. The stock, “off the shelf” mouthguard found in many retail stores with limited size offerings is the least expensive, but also least protective, of mouthguard types. Mouth-formed or “boil-and-bite” protectors, which are softened in boiling water and then bit down on by the player to form the fit, are better than the stock version — however, they often don’t cover all of the player’s back teeth.

The best option is a custom-designed guard made by a dentist for the individual patient. Although relatively expensive (costs range in the hundreds, compared with $25 or less for a stock guard), they provide the highest recognized level of mouth protection.

The bottom line: a mouthguard is a must-wear part of any uniform for any sport that involves contact or high velocity objects of play. If you or a family member is a contact sport athlete, it’s essential you protect your teeth and mouth with a custom-fit, high quality mouthguard.

If you would like more information on mouthguards, 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 “Athletic Mouthguards.”

By Drs Lawitts and Yeates
October 07, 2014
Category: Oral Health
ToothTraumaDoesntHavetoMeanToothLoss

Tooth decay and other oral diseases aren’t the only dangers your teeth face — accidental injuries also pose a risk. Fortunately, much can be done to save injured teeth, if you act quickly.

Dental injuries where part of the enamel crown has chipped off are the most common. Even if only one tooth appears damaged, adjacent teeth and bone might also have been damaged internally. Most chip injuries can be repaired either by reattaching the broken crown or with a tooth-colored filling or veneer. If the damage has extended into the inner tooth pulp then a root canal treatment might ultimately be necessary.

Teeth that have been knocked loose from normal alignment (dislodged) or where the entire tooth with its root has separated from the socket (avulsed) are rare but severe when they occur. It’s imperative to see a dentist as soon as possible — even more than five minutes’ of elapsed time can drastically reduce the tooth’s survivability. Dislodged teeth are usually splinted to adjacent teeth for several weeks; we would then carefully monitor the healing process and intervene with endodontic treatment (focused on the tooth’s interior) should something unfavorable occur.

With the possible exception of a primary (baby) tooth, an avulsed tooth should be placed back in the socket as soon as possible. This can be done by someone on scene, as long as the tooth is handled gently, the root not touched, and the tooth rinsed with cold, clean water if it has become dirty. If no one is available to do this, the tooth should be placed in milk to avoid drying out the root, and the patient and tooth transported to a dentist immediately. Once in the socket, the treatment is similar as for a dislodged tooth with splinting and careful watching.

The damaged tooth should be checked regularly. Your body’s defense mechanism could still reject it, so there’s a danger the root could be eaten away, or resorbed. Some forms of resorption can’t be treated — the aim then is to preserve the natural tooth for as long as possible, and then replace it with a life-like restoration to regain form and function.

If you would like more information on the treatment of injured teeth, 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 “Trauma & Nerve Damage to Teeth.”

By Drs Lawitts and Yeates
June 02, 2014
Category: Oral Health
KidsandSportsPreventingDentalInjuryWithMouthguards

There's nothing quite like watching your son or daughter compete on the athletic field. It's a mixture of anticipation, pride — and occasionally, anxiety. Despite all the protective gear and training, kids are sometimes injured playing the sports they love. In fact, when it comes to dental injuries, teens are the most susceptible of any age group. Here's what you should know about preventing sports-related dental injuries in kids.

Of course you know that football and hockey players should always wear mouthguards, both at games and during practice. But don't forget about kids who play soccer, do gymnastics, wrestle or play basketball. According to the American Dental Association (ADA) these athletes — along with participants in about 20 other sports — also need to wear this important piece of protective gear. In fact, the ADA states that not wearing a mouthguard makes an athlete 60 times more likely to sustain dental injury!

In selecting a mouthguard, there are three basic options to choose from: the “off-the-shelf” type, the so-called “boil and bite” protector, and the custom-fitted mouthguard that we can fabricate. Let's look briefly at all three.

The first type, available at many sporting goods stores, comes in a limited range of sizes, and an unknown range of quality. It's the least expensive option, offering a minimal level of protection that's probably better than nothing.

The second type, although popular, is also limited in its protection. This one is designed to be immersed in hot water, and then formed in the mouth using finger, tongue and bite pressure. If it can be made to fit adequately, it's probably better than the first type — though it often lacks proper extensions, and fails to cover the back teeth. Also, upon impact, the rubber-like material will distort and not offer as much protection as you would like to have.

The third is a piece of quality sports equipment that's custom-made for your child's mouth (or your own). To fabricate this mouthguard, we first make a model of the individual's teeth, and then mold the protector to fit just right. Made from tough, high-quality material, it's designed to cover all teeth, back and front, without being excessively bulky. It can even be made to accommodate growing teeth and jaws. And, it's reasonable in cost.

To paraphrase the ADA's recommendation, the best mouthguard is the one you wear. A comfortable, correctly-fitted mouthguard is easy to wear — and it can help prevent dental injury, giving you one less thing to worry about. Now, if you could just get you child to keep her eye on the ball.

If you have questions about mouthguards or sports-related dental injuries, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”

By Drs Lawitts and Yeates
April 25, 2014
Category: Oral Health
TheValueofMouthguards

Participating in athletic activities offers numerous well-documented health benefits — not to mention instilling the intangible values of discipline, teamwork and goal-setting. Of course, in nearly every sport, the possibility of injury exists as well. But don't let that stop you or someone you love from playing! Instead, you can learn about the potential hazards of dental injury, and take some practical steps to minimize the risk.

It should come as no surprise that injury to the mouth is an ever-present possibility in so-called “collision” sports like football and ice hockey. But did you know that the greatest number of dental injuries result from the games of baseball and basketball, which are often played informally? Even non-contact sports like skiing, bicycling and skateboarding carry a real risk of injury.

Who suffers dental injury? Men are slightly more likely than women — but only by a small percentage. Injury peaks in the teenage years, and seems to decrease afterward — but older athletes tend to have more severe problems. In short, most anyone who participates in sports is subject to possible dental injury.

Besides the obvious aesthetic imperfections, a damaged or missing tooth can also result in functional problems with the bite — a potentially serious condition. If a tooth can't be immediately replanted, restoring it can be expensive: The total cost of each tooth replacement is estimated at $10,000-$20,000 over a lifetime. So tooth damage or loss can cause a multitude of troubles.

The American Dental Association (ADA) has recommended that participants in all of the sports mentioned above — as well as two dozen others — should wear a custom-fitted mouthguard. Why? Because when it comes to dental injury, an ounce of prevention really is worth a pound of cure.

Numerous studies have shown that wearing a custom-fitted mouthguard is an effective way to prevent dental injury. According to the Academy of General Dentistry, mouthguards prevent some 200,000 injuries each year. And the ADA says that athletes who don't wear mouthguards are 60 times more likely to sustain harm to the teeth than those who do wear them.

Off-the-shelf mouthguards in a limited range of sizes are available at many sporting-goods stores. But these can't compare to the superior protection and durability offered by a mouthguard that's custom-made just for you. Using an exact model of your teeth, we can individually fabricate a piece of protective gear that fits correctly and feels comfortable in your mouth. A custom mouthguard may be more economical than you think — yet its real payoff comes in preventing dental injury.

If you have questions about mouthguards or sports-related dental injuries, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”



Dr. Karen Lawitts

Dr. Karen Lawitts

Dr. Nancy Yeates

Dr. Nancy Yeates

Dr. Lawitts was born and raised in Syracuse, NY. She received her Bachelor of Science and D.D.S degree from Northwestern University in Chicago. Dr. Nancy Yeates graduated from Canisius College with a B.A. in Biology. She then attended Georgetown University School of Dentistry.
       
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