Ask Dr Mike

Sports and Injuries
Published in the September,2010 Navesink Journal

Summer is over and the new school year is starting. With that begins a new sports season and a spike is sports related injuries. They range from dehydration, sprains, cuts, scrapes to broken bones and knocked out teeth. Many injuries can be prevented, but knowing what to do after the injury is very important for quick healing.

Dehydration
Avoiding dehydration is very important in overall health, but in also helping prevent other injuries. Staying hydrated improves performance and mental acuity. Dr. Michael Colgan suggests drinking 20 oz of water during every hour of exercise. You also should drink another 20 oz after you’re finished. Proper hydration is the key to a good recovery as well. Dr. Colgan says that a 2% decrease in hydration during an athletic event can result in a 20% decrease in performance.

Cuts and Scrapes
Every coach and parent should have a basic first aid kit available in order to treat minor cuts and scrapes. If the cut is bleeding, use a gauze pad and put firm direct pressure on the cut. Have someone call 911 if the cut is bad and stitches are needed.

Broken bones
If the athlete breaks a bone, have someone call 911 immediately. Stabilize the limb. Don’t allow the athlete to move around. Let the paramedics move the athlete safely.

Knocked out teeth
If an athlete knocks out a tooth, time is very important. You only have about 30 min to get a knocked out tooth back in place. The Academy for Sports Dentistry has made a list of things you can do to try to save a knocked out tooth:
1. Call the dentist immediately.
2. Do not handle the tooth by the root. Do not brush or scrub the tooth.
3. If there is debris, gently rinse with water.
4. If possible, try to re-implant the tooth and stabilize by gently biting down on a towel.
5. If not possible to re-implant: a) Place in Hank’s Balanced Saline Solution (Best)
b) Place in milk (2nd best)
c) Wrap tooth in Saline Soaked Gauze (3rd best)
d) Place under athlete’s tongue (4th best) Only if athlete is conscious.
Mouth guards
Mouth guards are a very important part of the athletes equipment. They can help protect the teeth from fractures or from getting knocked out. They also protect the lips from getting cut by the teeth if there is an accidental elbow or ball to the face.
Not all mouth guards are the same. There are three main categories of mouth guards listed below.

Boil and Bite Mouthguards
Boil and Bite mouth guards are the least expensive ( $5-$25)the least stable and least comfortable.
This is why you see so many athletes chewing on their guards between plays. They can’t wait to get them out.

Pressure Laminated Custom Mouthguard
These custom mouth guards fit much better than the boil and bite variety. A dentist takes an impression of your teeth and then vacuum fits the guard on model of your teeth. They are much more stable due to the material they are made with. These are the medium range of prices($75-$400). Prices vary depending on the materials and options.

Performance Enhancing Pressure Laminated Custom Mouth guard
These are the state of the art in custom mouth guards. Most of the SuperBowl Champion New Orleans Saints were wearing them last year. Gold, Silver and Bronze medal winner Bode Miller was wearing one during the Winter Olympics this year. Research has shown that when an athlete is in their most relaxed jaw position, the muscle of the face and neck relax allowing for the athlete to improve balance, flexibility and strength. Improving these areas are incredibly important in almost every sport. Due to the specification and technology involved these are the most expensive mouth guards ($600- $2500).
More information can be found on www.purepowermouthguard-ppm.com , or www.makkaradvantage.com. Also, the August Issue of “Men’s Journal” has a 3 page article on these new appliances.

This is a question we get fairly often.  Many times patients have teeth that become un-restorable.  It may be due to bone loss, fractured teeth, old posts that won’t stay in anymore, etc.  The answer to the question depends on a bunch of different factors including where it is, bone levels, the teeth next to the missing tooth, whether the patient smokes, and many more.

Option #1: Do nothing.

This is the cheapest option in the short term, but it may actually become the most expensive in the long run.  Over time, the teeth next to the space shift towards the space and can cause problems with the gums, bone and the bite.  It may require braces or other procedures to correct this down the road.  Also, when the missing tooth is in the front, aesthetics becomes a big concern.  This may make this choice not so good.

Option #2: A Removable Partial Denture

This is where you have an appliance made with metal or acrylic. It stays in by clasping onto other teeth in the mouth.  A portion of the appliance fills the missing tooth area with a plastic tooth.  This option can work very well for some, but for others, food getting caught under the partial, taking the partial in and out, and aesthetics make this not a good option.

Option #3: A Fixed Bridge

This option is a good option for many people.  It is where crowns are done on the teeth next to the space.  The framework of the bridge spans across the space over to the other crown.  The lab then creates a piece that looks like three teeth.  The bridge is cemented in and is not removable.  It can look very good, be very comfortable, easy to clean, etc.  There are factors that we need to think about when deciding that a bridge is right for the patient.  Are there fillings on the teeth next to the space?   How stable are those teeth?  What does the gum look like?  How big does the patient smile? What materials will work well?  A bridge is a great option for many, but what if the teeth next to the space have bone loss or crowns with very little natural tooth left?  Will they be strong enough in the long run to support all this?  Maybe,  maybe not.

Option #4: An Implant

This option is a great option for many people.  An implant is made of Titanium and placed into the space of the missing tooth.  Once the bone around the implant grabs onto the implant (integrates), the implant is ready to restore.  This integration takes about 3 months.  During this time, a temporary of some sort is used.  There are many factors that go into making an implant successful, but they are typically very long lasting, comfortable, aesthetic, and conservative.  With an implant you don’t have to do any restorations on the surrounding teeth.  This “keeps a one tooth problem, a one tooth solution”.  If you were to ever have a problem, it is only limited to that area.  I like to think of it as having a new tooth put in.  There are factors that make an implant more difficult, such as uneven gum levels, active gum disease, tooth width, and smoking.  Many of these issues can be overcome, but it does require some pre-planning.

As you can see, there is a lot to think about.  It is best to talk over you options with your dentist before finalizing your choice.

Now it’s Mom’s Turn

Your children have beautiful teeth thanks to the orthodontist. You look in the mirror and wish your teeth were straighter, but you don’t want braces.

Patients ask me all the time if there is something simple they can do to get straighter teeth without braces. The answer is Invisalign. This is an amazing procedure that can straighten your teeth with clear aligners.

How does it work?

Impressions of your teeth are made and sent to the Invisalign lab. The lab scans your impressions into a computer. The lab technician and the doctor communicate the desired result. Once approved the computer fabricates a series of clear aligners that fit over your teeth. Every two weeks you change the aligners. These aligners gradually move the teeth into the ideal position. Once completed a clear nighttime retainer is made to help maintain the position of the teeth.

Benefits of straight teeth

Straight teeth are not just for looks. Teeth that are well aligned have other benefits:

Healthier Gums – Properly positioned teeth are easier to brush and floss than teeth that are crowded, crooked, or spaced too far apart.

Easier Cleanings - With easier maintenance of good oral hygiene, plaque retention, tooth decay and gum disease risk can be reduced.

Decreased Risk of Dental Trauma and Abnormal Wear – Properly aligned teeth are less stressful on the supporting bone and jaw joints.

Smile More – Straightening your teeth can make you feel less self-conscious and more confident.

Invisalign is an amazing procedure that can help many people with their orthodontic needs. There are certain things that cannot be done with Invisalign, so treatment with standard orthodontics may still be recommended.

If you don’t have a dental home, you are welcome to call our office (732-224-1160) and schedule an appointment so we can discuss your unique situation.