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We’re used to seeing athletes wearing mouthguards at practice or play, because dental trauma is one of the most common (and predictable) sports injuries. But it’s not just athletes who are at risk, and there are some events in our daily lives that we just can’t predict. Car accidents, falls, workplace injuries, even innocent playground structures can take their toll on our smiles.

A major chip or a crack in your tooth is upsetting enough, and should be seen by Dr. Tom Nymberg as soon as possible. It’s even more unnerving when a tooth is knocked out completely. The technical term for a tooth which has been knocked out is an avulsed tooth, and it is a true dental emergency.

If you should suffer a partially or completely dislodged tooth, there is a possibility that your tooth can be reimplanted—if the damage isn’t too severe and if you get to our office immediately.

How can a lost tooth be saved? This is possible because of the complex biological engineering that anchors our teeth within the jaw. The root of a tooth is surrounded by the periodontal ligament. This connective tissue attaches the tooth to the alveolar bone of the jaw. When a tooth is knocked out, this ligament splits apart, leaving some tissue on the tooth root and some within the tooth’s socket.

To successfully reimplant a tooth, the connective tissue cells around the root of the tooth need to be vital, so that they can begin to reattach to the connective tissue left in the socket. Over time, this reattachment is complete, and the tooth becomes firmly anchored to the bone again.

It’s important to protect your tooth before you see Dr. Tom Nymberg to make sure there will be enough healthy tissue for reattachment. First of all,

• Don’t panic! If you or a friend or family member lose a tooth, call your dentist or your emergency health care provider as soon as possible. You will get specific instructions for your specific situation.

If you are unable to reach a healthcare provider immediately, there are some general rules for taking care of an avulsed tooth:

• Find the lost tooth. Don’t touch the root—use the crown, or top part of the tooth, to pick it up. You are trying to preserve and protect the connective tissue on the root surface.

• If the tooth is dirty, gently rinse it in milk, saliva, or water. Don’t wipe it off, though. You could damage those connective tissue cells mentioned above.

• Place the tooth back in the socket, if possible. Gently hold it in place with your fingers or bite down (again, gently). You can also place the tooth in your mouth next to your cheek.

• If returning the tooth to the socket is not an option, or if you are worried about a child possibly swallowing the tooth, keep the tooth moist. Whole milk or solutions sold just for the purpose of preserving an avulsed tooth are better choices than water, which damage the tissue cells on the root. And never wrap the tooth tightly—this can also damage the connective tissue.

Above all,

• Don’t delay! The faster a tooth is reimplanted in its socket, the greater chance you have of keeping it. Really, every minute counts. Reimplantations are more successful if they take place within 30 minutes. After an hour out of the mouth, your tooth’s chances of successful reintegration are lower—but still worth pursuing!

What will Dr. Tom Nymberg do?

• Evaluate the avulsed tooth.

There are variables which can affect whether or not a lost tooth is a good candidate for reimplantation. Trying to replace a baby tooth, for example, could interfere with the formation of the adult tooth. An adult tooth that is broken will probably require a different type of treatment.

• Prevent infection.

You might be given antibiotics and a referral to your medical doctor for a tetanus booster if needed.

• Clean the site.

The socket will be gently irrigated to clean the area and to remove any clots that may have formed which can interfere with the tooth’s placement.

• Recommend or perform a root canal.

Nerves and blood vessels within the tooth’s pulp generally don’t recover after a serious traumatic injury, so a root canal procedure could be necessary to preserve the health of your tooth. This procedure might be done immediately, or might be recommended for a later date.

• Stabilize your tooth.

The tooth must be stabilized after being reimplanted, so Dr. Tom Nymberg will use a splint to anchor the tooth to the teeth next to it. The splint can be flexible or rigid, depending on the condition of the alveolar bone. Splinting generally takes from two to eight weeks, and you will be given detailed instructions for taking care of the area while you heal.

Losing a tooth is an alarming experience. But with prompt action, and a trip to our Mason, OH office, it might be possible to make that loss only a temporary one.

HPV, or human papillomavirus, is the most common sexually transmitted infection in the country. There are over 100 strains of HPV, and, while most of these infections leave our systems on their own with no long-term ill effects, some cancers have been linked to certain “high risk” strains of the virus. One of these strains, HPV16, increases the risk of oral cancer.

HPV-related oral cancer most often appears in the oropharynx. This area of the mouth includes:

• The base, or back, of the tongue
• The soft palate
• The tonsils
• The back and sides of the throat

While HPV-related oral cancers can appear in other parts of the oral cavity, they most typically occur at the back of the throat and tongue and near the folds of the tonsils. Because of this location, oropharyngeal cancer can be difficult to detect. This is one more important reason to maintain a regular schedule of dental exams. Our examination doesn’t focus only on your teeth and gums. We are trained to look for cancerous and pre-cancerous conditions in the mouth, head, and neck to make sure you have the earliest treatment options should they be needed.

If you discover any potential symptoms of oropharyngeal cancer, call us for a check-up. These symptoms can include:

• Trouble moving the tongue
• Trouble swallowing, speaking, or chewing
• Trouble opening the mouth completely
• A red or white patch on the tongue or the lining of the mouth
• A lump in the throat, neck, or tongue
• A persistent sore throat
• Ear pain
• Unexplained weight loss
• Coughing up blood

Not every symptom is caused by cancer, but it is always best to be proactive. HPV-related oral cancer is rare, but it is on the increase. While HPV-positive oral cancers generally have a better prognosis than HPV-negative oral cancers, early diagnosis and treatment are still essential for the best possible outcome.

Finally, if you are a young adult or have an adolescent child, talk to Dr. Tom Nymberg and to your doctor about the HPV vaccine, which is effective before exposure to the virus occurs. Most HPV vaccines, while not designed specifically to prevent oral cancer, prevent the HPV16 strain from infecting the body—the very same strain that causes the majority of HPV-related oral cancers.  Although no studies have shown definitive proof yet, there is strong feeling in the scientific community that these immunizations might protect against HPV-positive oral cancer as well as cervical, vaginal, and other cancers. It’s a discussion worth having at your next visit to our Mason, OH office.

Fluoride has been one of the great game-changers in children’s dental health. Drinking fluoridated water. Using fluoride toothpaste. Scheduling fluoride treatments. All of these child-friendly dental habits help prevent cavities and strengthen tooth enamel.

And we adults enjoy the benefits of fluoride as well. Drinking fluoridated water. Using fluoride toothpaste. If only we hadn’t outgrown fluoride treatments… or have we? Time to have an adult conversation about fluoride treatments!

• To Start, Some Dental Chemistry

The enamel in our teeth is largely made of calcium and phosphate ions. These elements combine to form hydroxyapatite, the mineral crystals that make teeth and bones so hard and strong. But enamel isn’t indestructible. The oral bacteria in plaque create acids that cause demineralization, stripping away calcium and phosphate ions. This leaves the tooth surface weakened and vulnerable to decay.

Our bodies have a way of compensating for demineralization. Saliva is filled with calcium and phosphate ions that restore lost minerals. This balancing act goes on every day. When conditions in the mouth are too acidic, however, remineralization can’t take place as effectively. Here’s where fluoride is so beneficial.

• Why Fluoride?

First, because fluoride helps remineralize. Fluoride works on the surface of the tooth to attract the calcium and phosphate ions in our saliva, restoring them to our teeth. Even better, it joins with these ions to create fluorapatite. Fluorapatite crystals are larger, stronger, and more resistant to acids than hydroxyapatite. This means your teeth are not only remineralized, but stronger than they were originally!

• Why Adult Fluoride Treatments?

While fluoridated water and fluoride toothpaste might be all you need for strong enamel, there are several conditions that make fluoride treatments a good addition to your preventive care at our Mason, OH office.

• Problems with dental hygiene. Consider fluoride treatment if you have trouble brushing and flossing, if you wear braces, or if there’s any other reason that makes daily cleaning more difficult.
• Exposed roots. Gums often recede as we age, and can pull away from the teeth even further with added factors like gum disease, harsh brushing habits, teeth grinding, or smoking. As gums recede, parts of the tooth roots are exposed. Because roots are covered with cementum instead of the much harder enamel, they are more vulnerable to decay.
• Dry mouth. Medical conditions, medications, and aging can cause a decrease in saliva production. Because saliva helps wash away food particles and bacteria, bathes the teeth with minerals that strengthen enamel, and neutralizes acids, less saliva can equal more cavities.
• Our individual biology. Some of us are born with weaker tooth enamel, and so are more at risk for cavities—even with great brushing and flossing habits.

In all of these cases, fluoride treatments can provide the extra protection you might need for stronger tooth enamel and improved dental health.

• Treatments Are an Easy Addition to Your Dental Appointment

Regular fluoride treatments are neither complicated nor time-consuming. Fluoride can be administered as a varnish, a gel, a rinse, or a foam. It can be applied with a brush, a swab, as a mouthwash, or in a tray. After application, Dr. Tom Nymberg will let you know if any follow up instructions, such as avoiding food and drink for 30 minutes after treatment, are necessary. That’s all there is to it. Protection lasts for months, and your dentist can let you know when a re-application is needed.

You’re doing the right thing by using a fluoride toothpaste and keeping up with your dental exams and cleanings. Ask Dr. Tom Nymberg if a fluoride treatment is something that could strengthen your teeth and help prevent decay—it could be a game-changer for your dental health!

Dr. Tom Nymberg and our team at All Smiles Family Dental get this question a lot. Wisdom teeth are the last teeth to come in, once young people get their adult teeth. Because they are the last teeth to break through the gums, they are often called the third molars. There are four wisdom teeth: two on each side of the top and bottom of the mouth.

There is no hard-and-fast rule that says everyone must have the wisdom teeth removed. There are certain situations in which they either cause problems directly, or create a situation where there is a greater likelihood problems will arise eventually.

Impacted wisdom teeth

If Dr. Tom Nymberg and our team say you have a soft tissue impaction, it means your wisdom tooth is covered by gum tissue that is preventing it from erupting — most likely because your mouth is too small to provide the tooth with the room it needs to emerge.

The term “partial bony impaction” means that gum tissue is covering the wisdom tooth, but part of the jaw bone is also covering it, in which case there is no room in your mouth for the tooth to erupt. The opposite end of this spectrum is a complete bony impaction, where the wisdom tooth is completely covered by gum tissue and the jawbone, which prevent it from ever erupting.

The importance of removing impacted wisdom teeth

Dentists often want to remove impacted wisdom teeth because of the likelihood that they will cause problems, or because a problem already exists. One such problem is pericoronitis, an acute abscess that affects partially impacted wisdom teeth. Food, bacteria, and other mouth debris can become lodged under the gum flap that covers the wisdom tooth, which prevents it from erupting. Pericoronitis symptoms include pain, swelling, and the presence of an abscess.

Regular dental checkups will enable your dentist to keep an eye on your wisdom teeth, especially if they have some type of impaction. Dr. Tom Nymberg and our team at All Smiles Family Dental typically recommend removal of impacted wisdom teeth because of the likelihood that severe infections such as pericoronitis will develop.

If you have any questions about wisdom teeth, or if you would like to schedule an appointment with Dr. Tom Nymberg, please give us a call at our convenient Mason, OH office!