How to care for your dental appliance

Q. How often do you need to replace your dental appliance?

A. Probably more often than you do—if you don’t care for it properly!

Occasionally we have a patient who brings a distorted mouth guard or teeth-whitening tray to a dental appointment, and requests a new one. Since the damage to the appliance most commonly occurs as a result of an improper cleaning solution or improper storage, some information on proper care might be helpful to anyone who has such a dental appliance. These appliances are expensive to replace, but proper care can help them to last much longer.

The most common dental appliances are:

• A protective mouth guard, which is custom-fitted and helps prevent damage to the teeth and mouth during contact sports or other physical activity.

• A dental night guard, which is inserted at bedtime and fits snugly over the teeth to act as a cushion between the upper and lower teeth and which minimizes the effects of any grinding or clenching that might wear down the teeth.

• Snore guard: custom fitted snore guard positions the lower jaw forward using special connectors that are attached to upper and lower trays to minimize airway obstructions and snoring.

• A teeth-whitening tray, which is a custom-fitted, thin, flexible plastic tray that ensures proper application of a bleaching solution for at-home teeth-whitening.

• Invisalign Aligners: Custom made series of aligners used to straighten teeth.

The steps you can take to make your appliance last longer:

• Before using your appliance, rinse your guard with cool water;
• After using your appliance, wash it in cool, soapy water, and rinse it thoroughly; then brush it with a toothbrush and toothpaste;
• Soak the appliance in antiseptic mouth rinse for 10-15 minutes periodically, and then rinse it under cool water;
• Store and carry your appliance in a protective container that has openings for ventilation;
• Keep your appliance out of hot water or direct sunlight, because heat can distort it and affect its fit;
• Inspect your appliance regularly for wear and tear; and finally,
• If you observe any change or deterioration in your appliance, bring it to your dental checkup appointment to see if it needs replacement.

Your appliance was designed to do a job, but, if it’s not maintained in the proper condition, it’s not doing that job.

Remember, your dentist doesn’t want you to spend any more than you need to on protecting or whitening your teeth, and so it’s up to you to keep your appliance in good shape!

Editing by Veronica McDavid, WordsOnTheWebNY@gmail.com

Going Swimming? Shield Your Teeth!

Summer isn’t much fun if you can’t take a few plunges into a swimming pool, but, as we all know, pool water can dry out our skin and hair. What most people don’t know is that it can also permanently stain and erode our teeth.

 One study, published in the American Journal of Epidemiology back in 1986, concluded   that, out of 747 competitive swimmers surveyed, 39 percent suffered from enamel erosion of their teeth.

 http://aje.oxfordjournals.org/content/123/4/641.abstract

 In a more recent paper, in May 2011, dentists from the New York University College of Dentistry reported the case of a 52-year-old man who had complained of his teeth’s sensitivity, staining, and enamel loss—all symptoms that had come on quickly, in about five months. The only sudden change in the man’s routine was his newly adopted, 90-minutes-per-day swimming routine. Upon further inquiry, the researchers learned that the patient did not have professional pool maintenance, and he didn’t know the pH of his pool water. Their conclusion was that the pool water’s pH was to blame for the man’s dental problems.

http://www.nyu.edu/about/news-publications/news/2011/05/23/is-your-swimming-pool-safe-for-your-teeth.html

So, if you are lucky enough to have a swimming pool in your back yard, it is a good idea to have it maintained professionally. If you do choose to maintain it yourself, use pool pH strips to check the pH level of the water. If you keep the pH number at about 7.2-7.8, you should avoid spoiling your teeth!

Your Child Just Knocked His Tooth Out—Now What?

After handling an emergency for a friend’s child, I realized that a lot of moms did not know how to respond to the all-too-frequent crisis of a child’s tooth being knocked out. This post is written especially for moms, caregivers, coaches, teachers, and anyone else who might encounter just such a situation.

Studies tell us that about 25 percent of all school-age children experience some kind of dental injury, and about 0.6–16 percent of these dental injuries result in knocked-out teeth, or avulsion. This means that, in the United States alone, there are nearly five million schoolchildren each year who knock out a tooth. Since many dental injuries are sports related, the use of protective mouth guards and helmets can help, but, for routine school or home play, most children’s mouths have no protection. 

How Teeth Are Connected to the Bone

A very specialized connective tissue fiber, known as Periodontal Ligament (PDL), attaches a tooth to the bone. PDL acts as a “cushion” between tooth and bone and help a tooth withstand pressure from chewing.

What Happens When a Tooth Gets Knocked Out

When a tooth gets knocked out, the PDL fibers break. The knocked-out tooth will inevitably need a root-canal procedure at some point, but the key to success is the first response, which should be to maintain the vitality of the remaining fibers. Chances of root resorption (breakdown or loss of root structure) and ankylosis (fusion of the tooth to the bone) will decrease if the tooth can be re-implanted in the socket properly and in a timely manner.

First, look at a tooth that was just knocked out, and determine whether the tooth is a primary (baby) tooth or an adult tooth; then follow these instructions:

A Baby Tooth

If the tooth is a baby tooth, do not try to re-insert it into the socket. Doing so risks damaging the adult tooth that is developing under the knocked-out baby tooth, and, since the four front baby teeth do not “hold the space” for adult teeth, there is no need for re-implanting anyway.

A Permanent Tooth

If the tooth Is a permanent tooth, and the root has not been damaged by the injury, it might have a reasonable chance of reattaching if it can be re-implanted in the socket within one hour from the time it was knocked out. You can try to re-insert the tooth in the socket, or you can transport the tooth (and the child) to the dentist as soon as possible.

To re-insert the tooth:

• Taking care not to touch the “root” and handling the tooth only by holding the “crown” part of the tooth, rinse it very gently with cold water to remove dirt, if necessary. Do not scrub or scrape the tooth.
• Look at the shape of the side teeth to determine the correct position of the tooth, and then try to re-insert the tooth in the socket. Hold it in position with light pressure. Then, take the patient to the dentist as soon as possible, so he or she can stabilize the tooth in the correct position with a flexible splint.

Transporting the Tooth

If for any reason you are not able to re-implant the tooth, you need to place the tooth in a safe medium and transport it to the dentist immediately:

• If the patient is healthy and over six years of age, have him place the tooth under his tongue, where the “safe medium” is the child’s own saliva;
• If the child is too young or cannot be trusted to hold the tooth in his mouth safely, place the tooth in a container and cover it with milk (any fat content), and take it to the dentist immediately; or
• When it is available, use “Hanks solution,” which is commercially available as a “Save-a-Tooth” kit.  (This is a pH-balanced cell-preserving solution that has been extensively tested.)

The long-term prognosis for replanted knocked-out teeth is very variable. Fully mature adult teeth, with completely formed roots, have a better chance of survival than immature teeth, and teeth with less time outside the tooth socket have a better chance than those with more time outside the socket.

Of course, we all aspire to sports safety, in order to prevent dental injuries, but, even with our best efforts, accidents occur. Don’t panic, but to be prepared, you need to be informed, and that is the purpose of my giving you this important information.

Understanding Dentistry and Sports

The ultimate goal in sports is not just to win but to win without any injury. Adequate preparation and training are key elements in minimizing or preventing injuries in sports. Popularly known as sports dentistry, this field aims to prevent and provide treatment to oral/facial trauma that may occur during sporting activities.

Several ways to prevent oral/facial trauma include:
• Teaching the right skills, including tackling technique
• Buying the right sports equipment
• Regular maintenance of sports equipment
• Providing safe playing areas
• Wearing of properly fitted sports protective equipment such as mouth guards

Facts from the National Youth Sports Foundation for Safety, from the American Dental Association and the California Dental Association Dental injuries are the most common type of orofacial injury sustained during participation in sports; the majority of these dental injuries are preventable. An athlete is 60 times more likely to sustain damage to the teeth when not wearing a protective mouthguard. The cost of a fractured tooth is many times greater than the cost of a dentist diagnosed and designed professionally made mouthguard. Every athlete involved in contact sport has about a 10% chance per season of an orofacial injury, or a 33-56% chance during an athletic career. The cost to replant a tooth and the follow-up dental treatment is about $5000. Victims of knocked out teeth who do not have a tooth properly preserved or replanted may face lifetime dental costs of $15,000-$20,000/tooth, hours in the dental chair, and the possible development of other dental problems such as periodontal disease. It is estimated that faceguards and mouthguards prevent approximately 200,000 injuries each year in high school and college football. The stock mouthguard which is bought at sports stores without any individual fitting, provide only a low level of protection, if any. If the wearer is rendered unconscious, there is a risk the mouthguard may lodge in the throat potentially causing an airway obstruction. A properly fitted mouthguard reduces the chances of sustaining a concussion from a blow to the jaw. Mouthguards should be worn at all times during competition; in practice as well as in games. The American Dental Association recommends wearing custom mouthguards for the following sports: acrobats, basketball, boxing, field Hockey, football, gymnastics, handball, ice hockey, lacrosse, martial arts, racquetball, roller hockey, rugby, shot putting, skateboarding, skiing, skydiving, soccer, squash, surfing, volleyball, water polo, weightlifting, wrestling.

SmilePlus Dentistry provides custom fitted mouth guards and treatment of most common sports dental injuries.Please call our office at 510-796-1656  if you have further questions related to this topic.