My Blog
By David G. Feeney, DDS
July 21, 2021
Category: Oral Health
Tags: dental injury  
TakeTheseImmediateActionstoSaveaKnocked-OutTooth

Accidents do happen, especially if you or a family member has an active lifestyle. One such risk, especially for someone playing a contact sport, is having a tooth knocked out.

But as extreme as this injury can be, it doesn't necessarily mean the tooth is lost forever. Gum (or periodontal) cells remaining on the tooth root can regenerate and regain their attachment with the periodontal ligament that holds teeth in place. But you have to act quickly—the longer the tooth is out of the socket, the more likely these cells will dry out and die.

So, by doing the following within 5-20 minutes of the injury (and the earlier the better), that knocked-out tooth has a reasonable chance of survival.

Locate and clean the tooth. Your first priority is to find the missing tooth and clean it of any debris with clean water. Be sure not to touch the root of the tooth and only handle the tooth by the crown (the visible part of a tooth when it's in the mouth).

Insert the root end into the empty socket. Still holding the tooth by the crown, insert the opposite root end into the empty socket. Orient the crown properly, but don't worry about getting it in just right—the follow-up with the dentist will take care of that. You will, however, need to apply some pressure to get it to seat firmly.

Secure the tooth. Place a piece of clean gauze or cloth between the reinserted tooth and its counterpart on the other jaw. Then, have the person bite down on the cloth and hold it. This will help secure the tooth in place while you travel to the dentist.

Seek dental care immediately. It's important to see a dentist immediately to adjust the tooth's position and to possibly splint the tooth to better secure it while it heals. If a dentist isn't available, then visit a local emergency room instead.

Taking these actions on the scene could mean the difference between saving and losing a tooth. But act quickly—the sooner you initiate first aid for a knocked-out tooth, the better its chances for long-term survival.

If you would like more information on what to do during dental emergencies, 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 David G. Feeney, DDS
July 11, 2021
Category: Dental Procedures
Tags: root canal  
DontFeartheRootCanal-ItCouldJustSaveYourTooth

Root canals often get a bum rap. Although the procedure saves millions of teeth every year, it's often erroneously portrayed as an unpleasant experience. And if that wasn't enough, a long-discredited medical theory has found new life on the internet asserting root canals are a health danger.

First off, root canals play an immensely important role in treating teeth with advanced decay. If not promptly treated, a cavity can turn into a major infection of the interior tooth pulp and root canals, and ultimately the supporting bone. Teeth with this level of decay are not long for this world.

A root canal treatment stops this disease process in its tracks. After numbing the tooth and surrounding gums, we drill a small hole into the tooth's interior and then remove all of the infected tissue within the pulp and root canals. After disinfecting these areas, we fill them with a rubber-like substance called gutta percha.

After sealing off the access hole—and later capping the tooth with a life-like crown—the tooth is secure from further decay. And, by the way, the procedure doesn't hurt, thanks to local anesthesia. If anything, any pain caused by the decay attacking the tooth's nerves has now been alleviated.

So, what about the idea floating on the Web that root canals are dangerous? The "root" for this conjecture is a theory by Weston Price, an early 20th Century dentist, that leaving a "dead" body part in the body leads to various health problems (including cancer). That would include a root-canaled tooth, which has had the living tissue in the pulp removed.

There's just one problem—Weston's theory was fully investigated in the 1950s and overwhelmingly discredited. The supposed cancer threat was also reviewed in a 2013 study, which found no link between root canals and increased cancer risk. In fact, dental patients who had undergone several root canals had a diminished risk.

Like all other health procedures, root canals have some risks of complication. But those complications are far from life-threatening—it's tooth-saving benefits are often worth the risk. So, fear not if your dentist says you need a root canal. It won't hurt and it won't endanger your health—and it could save your tooth.

If you would like more information on root canal therapy, 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 “Root Canal Safety.”

By David G. Feeney, DDS
July 01, 2021
Category: Oral Health
Tags: thumb sucking  
ThumbSuckingandTongueThrustingCouldCauseaPoorBite

There are many things to be concerned about with your infant. Thumb sucking shouldn't be one of them—at least not yet. Practically universal among young children, the habit normally fades by age four with no real harm.

If it persists beyond that age, however, it can lead to a poor bite (malocclusion). Late thumb sucking may also have a connection with another problem—the inability of a child to transition from an infantile swallowing pattern to an adult pattern.

A baby while swallowing thrusts their tongue forward to help create a seal around a breast or bottle nipple during nursing. This normally changes about age 4, though, to a positioning of the tongue against the roof of the mouth when swallowing. But if they don't transition and continue to thrust the tongue forward, it can place undue pressure on the front teeth and cause them to develop too far forward.

The result may be an open bite, in which a gap exists between the upper and lower teeth even when the jaws are shut. An open bite can also happen with late thumb sucking, but instead of the tongue, their thumb presses against the teeth.

As to thumb-sucking, parents should encourage their child to stop the habit beginning around age 3, if they haven't already begun to do so. The best approach is to use some form of positive reinforcement such as praise or treats. The sooner the habit ceases after age 4, the lower their risk for developing an open bite.

You may also need to be alert to continued tongue thrusting while swallowing, which may still continue even after they no longer suck their thumb. In that case, your child may need orofacial myofunctional therapy (OMT), a series of exercises directed by a trained therapist to retrain the muscles involved with swallowing. This therapy could further help a child properly transition to an adult swallowing pattern.

Open bites can be corrected orthodontically later in life. But by being alert to your child's oral habits, as well as the way they're swallowing, you and your dentist may be able to intervene and eliminate or at least lessen the development of this type of problem bite.

If you would like more information on how to manage thumb sucking, 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 “How Thumb Sucking Affects the Bite.”

VanHalensPassingRemindsUsoftheDangersofOralCancerandHowtoHelpPreventIt

Fans everywhere were recently saddened by the news of musical legend Eddie Van Halen's death. Co-founder and lead guitarist for the iconic rock group Van Halen, the 65-year-old superstar passed away from oral cancer.

Van Halen's rise to worldwide fame began in the 1970s with his unique guitar style and energetic performances, but behind the scenes, he struggled with his health. In 2000, he was successfully treated for tongue cancer. He remained cancer-free until 2018 when he was diagnosed with throat cancer to which he succumbed this past October.

Van Halen claimed the metal guitar picks he habitually held in his mouth caused his tongue cancer. It's more likely, though, that his heavy cigarette smoking and alcohol use had more to do with his cancers.

According to the American Cancer Society, most oral cancer patients are smokers and, as in Van Halen's case, are more likely to beat one form of oral cancer only to have another form arise in another part of the mouth. Add in heavy alcohol consumption, and the combined habits can increase the risk of oral cancer a hundredfold.

But there are ways to reduce that risk by making some important lifestyle changes. Here's how:

Quit tobacco. Giving up tobacco, whether smoked or smokeless, vastly lowers your oral cancer risk. It's not easy to kick the habit solo, but a medically supervised cessation program or support group can help.

Limit alcohol. If you drink heavily, consider giving up alcohol or limiting yourself to just one or two drinks a day. As with tobacco, it can be difficult doing it alone, so speak with a health professional for assistance.

Eat healthy. You can reduce your cancer risk by avoiding processed foods with nitrites or other known carcinogens. Instead, eat fresh fruits and vegetables with antioxidants that fight cancer. A healthy diet also boosts your overall dental and bodily health.

Practice hygiene. Keeping teeth and gums healthy also lowers oral cancer risk. Brush and floss daily to remove dental plaque, the bacterial film on teeth most responsible for dental disease. You should also visit us every six months for more thorough dental cleanings and checkups.

One last thing: Because oral cancer is often diagnosed in its advanced stages, be sure you see us if you notice any persistent sores or other abnormalities on your tongue or the inside of your mouth. An earlier diagnosis of oral cancer can vastly improve the long-term prognosis.

Although not as prevalent as other forms of cancer, oral cancer is among the deadliest with only a 60% five-year survival rate. Making these changes toward a healthier lifestyle can help you avoid this serious disease.

If you would like more information about preventing oral cancer, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “How a Routine Dental Visit Saved My Life” and “Strategies to Stop Smoking.”

By David G. Feeney, DDS
June 11, 2021
Category: Oral Health
Tags: oral hygiene  
ManagingOralHealthIsanImportantPriorityforHIV-AIDPatients

Forty years have passed since the first reported case of Acquired Immune Deficiency Syndrome (AIDS), and it and the human immunodeficiency virus (HIV) that causes it are still with us. About 1.2 million Americans are currently infected with HIV, with 50,000 new cases diagnosed each year.

The emergence of antiretroviral drugs, though, has made it possible for many with HIV to live normal lives. Even so, the virus can still have a profound effect on health, including the teeth and gums. Because of its effect on the immune system, HIV+ patients are at greater risk for a number of oral conditions, like a fungal infection called candidiasis ("thrush").

Another common problem is chronic dry mouth (xerostomia), caused by a lack of saliva production. Not only does this create an unpleasant mouth feel, but the absence of saliva also increases the risk for tooth decay and periodontal (gum) disease.

The latter can be a serious malady among HIV patients, particularly a severe form of gum disease known as Necrotizing Ulcerative Periodontitis (NUP). With NUP, the gums develop ulcerations and an unpleasant odor arising from dead gum tissue.

Besides plaque removal (a regular part of gum disease treatment), NUP may also require antibiotics, antibacterial mouthrinses and pain management. NUP may also be a sign that the immune system has taken a turn for the worse, which could indicate a transition to the AIDS disease. Dentists often refer patients with NUP to a primary care provider for further diagnosis and treatment.

Besides daily brushing and flossing, regular dental cleanings are a necessary part of a HIV+ patient's health maintenance. These visits are also important for monitoring dental health, which, as previously noted, could provide early signs that the infection may be entering a new disease stage.

It's also important for HIV+ patients to see their dentist at the first sign of inflamed, red or bleeding gums, mouth lesions or loose teeth. Early treatment, especially of emerging gum disease, can prevent more serious problems from developing later.

Living with HIV-AIDS isn't easy. But proper health management, including for the teeth and gums, can help make life as normal as possible.

If you would like more information on dental care and HIV-AIDS, 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 “HIV-AIDS & Oral Health.”





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