Posts for category: Oral Health

By Dr. Edwin J. Szczepanik, D.M.D.
March 07, 2019
Category: Oral Health
DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”

By Dr. Edwin J. Szczepanik, D.M.D.
January 16, 2019
Category: Oral Health
Tags: gum recession  
WatchOutforSignsofGumRecession

Your gums aren’t just for show—they also play an important role in supporting and protecting your teeth. Healthy gums are essential for healthy teeth.

Your gums can take a lot from daily chewing or other environmental factors. Unfortunately, disease or trauma can weaken their resilience. This weakening could lead to gum recession.

Gum recession occurs when the tissues covering a tooth begin to lose their attachment and shrink back (recede). As a result, the tooth appears “longer” as more of it that’s normally below the gum line becomes visible. Not only is gum recession unattractive, it also exposes more of the tooth to disease-causing bacteria.

The most common cause for gum recession is periodontal (gum) disease, an infection arising from the accumulation of a thin bacterial biofilm on the teeth called plaque. Infected gums become inflamed, a normal defensive response to isolate diseased or damaged tissues from the rest of the body. Chronic inflammation, however, weakens affected tissues over time and results in bone loss.

Other factors can also contribute to gum recession. A tooth that didn’t erupt properly and has come in away from the center of its protective bony housing can impede adequate gum coverage. Your gum tissue thickness, which you genetically inherit, can also increase the risk of gum recession. People with thinner gum tissues are more susceptible to recession than with thicker tissues.

You can also damage your gums (ironically) while trying to care for them. Over-aggressive brushing over time may traumatize the gums to the point that they recede. While it’s essential in removing disease-causing dental plaque, brushing only requires a gentle scrubbing action covering all portions of tooth surfaces. The brush bristles and mild abrasives in the toothpaste do most of the work of plaque removal.

To minimize the chances of gum recession, you should practice proper oral hygiene and visit your dentist regularly for professional cleanings and checkups. And you might also consider orthodontics for improperly positioned teeth that could not only improve your smile, but also your gum health.

And by all means see your dentist if you notice any signs of gum infection like swollen, reddened or bleeding gums. The sooner you begin gum disease treatment, the less likely your gums will recede in the future.

If you would like more information on recognizing and treating gum recession, 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 “Gum Recession: Getting Long in the Tooth.”

By Dr. Edwin J. Szczepanik, D.M.D.
January 06, 2019
Category: Oral Health
Tags: mouthguards  
WanttoKeepEnjoyingWinterSportsWearaMouthguard

What's your favorite winter sport? For some, it's all about swooshing down a snowy trail on skis, a board, or a sled. For others, the main attraction is skating at an ice rink or a frozen pond. If you're more of an indoors athlete, you may enjoy a fast-moving game of basketball or a round of squash. Or, you might take a turn on a climbing wall or a trampoline.

What do all these activities have in common? They're fun, they're great exercise…and they all come with a risk of injury to your teeth.

It's easy to see how a collision on snow or ice could result in a blow to the mouth. But did you know that basketball (along with hockey) is among the sports with the highest risk of facial injury? What's more, many "non-contact" sports actually have a similar risk.

Located front and center in the face, the incisors (front teeth) are the ones most likely to sustain injury. Unfortunately, they are also the most visible teeth in your smile. With all of the advances in modern dentistry, it's possible to restore or replace damaged teeth in almost any situation—but the cost can be high, both for present restoration and future preservation. Is there a better alternative?

Yes! It isn't sitting at home—it's wearing a custom-made mouthguard when there's a risk of facial injury.

Most people don't ski or play hockey without protective gear like a helmet. A mouthguard can effectively protect against dental injury that might otherwise be serious. Available here at the dental office, a custom mouthguard is made from an exact model of your own teeth, so it's comfortable to wear and fits perfectly—but no safety equipment can work if you don't use it!

So whether you like to hit the trails or the gym this winter, don't forget to bring a custom-made mouthguard. It's a small piece of gear that can save you from a big headache!

If you would like more information on mouthguards, please contact us or schedule a consultation. You can learn more by reading the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”

By Dr. Edwin J. Szczepanik, D.M.D.
December 27, 2018
Category: Oral Health
Tags: medicine  
NSAIDsCouldbeJustasEffectiveasNarcoticsManagingDentalPain

Like other healthcare providers, dentists have relied for decades on the strong pain relief of opioid (narcotic) drugs for patients after dental work. As late as 2012, doctors and dentists wrote over 250 million prescriptions for these drugs. Since then, though, those numbers have shrunk drastically.

That’s because while effective, drugs like morphine, oxycodone or fentanyl are highly addictive. While those trapped in a narcotic addiction can obtain drugs like heroine illicitly, a high number come from prescriptions that have been issued too liberally. This and other factors have helped contribute to a nationwide epidemic of opioid addiction involving an estimated 2 million Americans and thousands of deaths each year.

Because three-quarters of opioid abusers began their addiction with prescription pain medication, there’s been a great deal of re-thinking about how we manage post-procedural pain, especially in dentistry. As a result, we’re seeing a shift to a different strategy: using a combination of non-steroidal anti-inflammatory drugs (NSAIDs), particularly ibuprofen and acetaminophen, instead of a prescribed narcotic.

These over-the-counter drugs are safer and less costly; more importantly, though, they don’t have the high addictive quality of an opioid drug. A 2013 study published in the Journal of the American Dental Association (JADA) showed that when two NSAIDs were used together, the pain relief was greater than either drug used individually, and better than some opioid medications.

That’s not to say dentists no longer prescribe opioids for pain management following dental work. But the growing consensus among dental providers is to rely on the double NSAID approach as their first-line therapy. If a patient has other medical conditions or the NSAIDs prove ineffective, then the dentist can prescribe an opioid instead.

There’s often hesitancy among dental patients on going this new route rather than the tried and true opioid prescription. That’s why it’s important to discuss the matter with your dentist before any procedure to see which way is best for you. Just like you, your dentist wants your treatment experience to be as pain-free as possible, in the safest manner possible.

If you would like more information on how dentists are safely managing pain in dental care, please contact us or schedule an appointment for a consultation.

By Dr. Edwin J. Szczepanik, D.M.D.
December 17, 2018
Category: Oral Health
Tags: celebrity smiles   retainer  
FanofSuperheroFilmBlackPantherBreaksSteelWirewithHerMouth

Some moviegoers have been known to crunch popcorn, bite their fingers or grab their neighbor’s hands during the intense scenes of a thriller. But for one fan, the on-screen action in the new superhero film Black Panther led to a different reaction.

Sophia Robb, an 18-year-old Californian, had to make an emergency visit to the orthodontic office because she snapped the steel wire on her retainer while watching a battle scene featuring her Hollywood crush, Michael B. Jordan. Her jaw-clenching mishap went viral and even prompted an unexpected reply from the actor himself!

Meanwhile, Sophia got her retainer fixed pronto—which was exactly the right thing to do. The retention phase is a very important part of orthodontic treatment: If you don’t wear a retainer, the beautiful new smile you’re enjoying could become crooked again. That’s because if the teeth are not held in their new positions, they will naturally begin to drift back into their former locations—and you may have to start treatment all over again…

While it’s much more common to lose a removable retainer than to damage one, it is possible for even sturdy retainers to wear out or break. This includes traditional plastic-and-wire types (also called Hawley retainers), clear plastic retainers that are molded to fit your teeth (sometimes called Essix retainers), and bonded retainers: the kind that consists of a wire that’s permanently attached to the back side of your teeth. So whichever kind you use, do what Sophia did if you feel that anything is amiss—have it looked at right away!

When Black Panther co-star Michael B. Jordan heard about the retainer mishap, he sent a message to the teen: “Since I feel partly responsible for breaking your retainers let me know if I can replace them.” His young fan was grateful for the offer—but even more thrilled to have a celebrity twitter follower.

If you have questions about orthodontic retainers, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Importance of Orthodontic Retainers” and “Bonded Retainers.”



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