Boston Bruins defenseman Zdeno Chara had a rough Stanley Cup final against the St. Louis Blues this past June. Not only did the Bruins ultimately lose the championship, but Chara took a deflected puck shot to the face in Game Four that broke his jaw.
With the NHL season now over, the 42-year-old Bruins captain continues to mend from his injury that required extensive treatment. His experience highlights how jaw fractures and related dental damage are an unfortunate hazard in hockey—not only for pros like Chara, but also for an estimated half million U.S. amateurs, many in youth leagues.
Ice hockey isn't the only sport with this injury potential: Basketball, football (now gearing up with summer training) and even baseball players are also at risk. That's why appropriate protective gear like helmets and face shields are key to preventing injury.
For any contact sport, that protection should also include a mouthguard to absorb hard contact forces that could damage the mouth, teeth and gums. The best guards (and the most comfortable fit) are custom-made by a dentist based on impressions made of the individual's mouth.
But even with adequate protection, an injury can still happen. Here's what you should do if your child has an injury to their jaw, mouth or teeth.
Recognize signs of a broken jaw. A broken jaw can result in severe pain, swelling, difficulty speaking, numbness in the chin or lower lip or the teeth not seeming to fit together properly. You may also notice bleeding in the mouth, as well as bruising under the tongue or a cut in the ear canal resulting from jawbone movement during the fracture. Get immediate medical attention if you notice any of these signs.
Take quick action for a knocked-out tooth. A tooth knocked completely out of its socket is a severe dental injury. But you may be able to ultimately save the tooth by promptly taking the following steps: (1) find the tooth and pick it up without touching the root end, (2) rinse it off, (3) place it back in its socket with firm pressure, and (4) see a dentist as soon as possible.
Seek dental care. Besides the injuries already mentioned, you should also see a dentist for any moderate to severe trauma to the mouth, teeth and gums. Leading the list: any injury that results in tooth chipping, looseness or movement out of alignment.
Even a top athlete like Zdeno Chara isn't immune to injury. Take steps then to protect your amateur athlete from a dental or facial injury.
If you would like more information about dealing with sports-related dental injuries, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Athletic Mouthguards” and “The Field-Side Guide to Dental Injuries.”
When you’re buying a tool or appliance, you compare brands for the best quality you can afford. There’s another important item that deserves the same level of scrutiny: your toothbrush. Choosing the right one for you can make a huge difference in your oral hygiene effectiveness.
But a visit to your store’s dental care aisle can dim your enthusiasm. You have plenty of options involving all manner of shapes, sizes and features. Perhaps too many: After a while, the sheer number of choices can paralyze your decision-making process.
You can streamline this selection process by concentrating on a few important toothbrush basics. First up for consideration: the bristles. While you may think a good stiff brush would be best, it’s actually the opposite—most dental professionals recommend softer bristles. That’s because hard bristles can potentially damage your teeth and gums over time.
Softer bristles are gentler on your teeth and just as effective for removing plaque, if you use the right technique and thoroughly brush all tooth surfaces. And look for rounded bristles, which are friendlier to your gums.
Next, look for a brush that feels right in your hand. If you have problems with manual dexterity, look for one with an oversized handle. Some brushes come with angled necks and tapered heads, which you may find effective in reaching less accessible back teeth. This might mean trying different brushes until you get one that’s right for you. Don’t worry, though, you’re not buying a brush for life—in fact, you should change out your brush every three to six months.
You’ll also rarely go wrong buying a toothbrush with the American Dental Association Seal of Acceptance on the packaging. This seal signifies the toothbrush has undergone testing and met the ADA’s standards for hygiene effectiveness. While some manufacturers of effective brushes don’t pursue this seal, you can be sure one with it has passed the test of quality.
It makes all the difference in the world having the right tool for the job. Be sure your toothbrush is the right one for you.
If you would like more information on toothbrushes and other dental care products, 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 “Sizing up Toothbrushes: How to Choose the Right Brush for Optimal Oral Health.”
A certain news story a few years ago notwithstanding, dentists still recommend flossing along with brushing to adequately remove disease-causing plaque. If there is any controversy at all about flossing, it's whether you should perform it before brushing or after. Each perspective has good reasons.
"Brush First" proponents say their way encourages the formation of a daily hygiene habit, a must for preventing disease. That's because brushing can remove most of the plaque built up on the teeth, while flossing can then remove what's left. If you floss first, though, you'll have to plow through the sticky film with the floss, which can be an unpleasant experience. Facing that every day could make a person less enthusiastic about developing a hygiene habit.
But it's not just about the sensation: depending on the person, the plaque buildup could be so much that the floss becomes clogged with it. You're then moving the plaque rather than removing it. Brushing a lot of the plaque out of the way first will increase the cleaning power of your floss.
The "Floss First" team, though, is undaunted with their own take on the matter. Flossing can loosen up any stuck debris between teeth, making it easier for brushing to clear it away. It can also expose plaque-covered areas between teeth to allow better contact with the fluoride in your toothpaste. And, the amount of plaque you're pulling out in certain areas during flossing could tip you off to beef up your brushing efforts on those areas of heavier plaque accumulation.
One of the prime reasons for flossing first, though, goes back to the comfort factor and human nature. To be honest, for most people flossing isn't as much "fun" as brushing. If you put it off until after brushing, you're more likely not to do it if you find it unpleasant. Doing it first gets the less likeable task out of the way, so you can then do the more likeable one, brushing.
Which approach is best for you? It's really a personal decision, one you can discuss with your dentist. Try both ways, and see which one seems better. But whether you floss first or last, do floss to really reduce your risk for dental disease.
If you would like more information on best oral hygiene 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 “Brushing and Flossing: Which Should be Done First?”
Most dental procedures today only require local anesthesia to numb just the affected area. It's a safer approach than general anesthesia: the unconscious state created by putting someone "to sleep" can lead to some unpleasant complications.
But patient comfort involves more than preventing physical pain during a procedure. There's also the emotional factor—many people experience nervousness, anxiety or fear during dental visits. It's especially problematic for an estimated 15% of the population whose dental visit anxiety is so great they often try to avoid dental care altogether.
One option is to use general anesthesia for patients with acute anxiety rather than local anesthesia. This removes them consciously from their anxiety, but they must then be monitored closely for complications.
But there's a safer way to relax patients with high anxiety called intravenous or IV sedation. The method delivers a sedative medication directly into a patient's bloodstream through a small needle or catheter inserted into a vein. The sedative places the patient in a relaxed "semi-awake" state, taking the edge off their anxiety while still enabling them to respond to verbal commands.
Coupled with local anesthesia, they won't experience any pain and very little if any discomfort. And many of the sedatives used also have an amnesiac effect so that the patient won't remember the procedures being performed.
IV sedation does require monitoring of vital signs, but the patient won't need help maintaining their breathing or heart function. And although the medication can be adjusted to reduce any lingering after-effects, a patient will still need someone to accompany them to and from their visit.
For lesser anxiety or nervousness, dentists sometimes prescribe an oral sedative to take just before a visit. This can help take the edge off your nerves and help you relax. With either method, though, sedation can help you overcome fear and anxiety and have a more pleasant treatment experience.
If you would like more information on IV sedation, 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 “IV Sedation in Dentistry.”
Fans of the primetime TV show The Middle were delighted to see that high school senior Sue, played by Eden Sher, finally got her braces off at the start of Season 6. But since this popular sitcom wouldn’t be complete without some slapstick comedy, this happy event is not without its trials and tribulations: The episode ends with Sue’s whole family diving into a dumpster in search of the teen’s lost retainer. Sue finds it in the garbage and immediately pops it in her mouth. But wait — it doesn’t fit, it’s not even hers!
If you think this scenario is far-fetched, guess again. OK, maybe the part about Sue not washing the retainer upon reclaiming it was just a gag (literally and figuratively), but lost retainers are all too common. Unfortunately, they’re also expensive to replace — so they need to be handled with care. What’s the best way to do that? Retainers should be brushed daily with a soft toothbrush and liquid soap (dish soap works well), and then placed immediately back in your mouth or into the case that came with the retainer. When you are eating a meal at a restaurant, do not wrap your retainer in a napkin and leave it on the table — this is a great way to lose it! Instead, take the case with you, and keep the retainer in it while you’re eating. When you get home, brush your teeth and then put the retainer back in your mouth.
If you do lose your retainer though, let us know right away. Retention is the last step of your orthodontic treatment, and it’s extremely important. You’ve worked hard to get a beautiful smile, and no one wants to see that effort wasted. Yet if you neglect to wear your retainer as instructed, your teeth are likely to shift out of position. Why does this happen?
As you’ve seen firsthand, teeth aren’t rigidly fixed in the jaw — they can be moved in response to light and continuous force. That’s what orthodontic appliances do: apply the right amount of force in a carefully controlled manner. But there are other forces at work on your teeth that can move them in less predictable ways. For example, normal biting and chewing can, over time, cause your teeth to shift position. To get teeth to stay where they’ve been moved orthodontically, new bone needs to form around them and anchor them where they are. That will happen over time, but only if they are held in place with a retainer. That’s why it is so important to wear yours as directed — and notify us immediately if it gets lost.
And if ever you do have to dig your retainer out of a dumpster… be sure to wash it before putting in in your mouth!
If you would like more information on retainers, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Why Orthodontic Retainers?”
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