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.”
For whatever reason, you’ve put off replacing a missing tooth for awhile. Now you want to fill that empty gap in your smile with a dental implant restoration.
But if your tooth’s been missing for a long time, there could be a problem with space. This is because the teeth on either side of the space may have gradually drifted into it, leaving no room for the implant. You could need orthodontic work first to return these teeth to their proper position.
We could use braces, metal orthodontic devices with wires threaded through brackets bonded to the teeth that are then anchored, usually to back teeth. The orthodontist uses elastics or springs as well as possibly incrementally tightening of the wire against the anchors. These techniques create pressure or tension on the teeth for the desired direction of movement. The teeth’s natural mechanism for movement does the rest.
But while effective, braces can be quite noticeable, an embarrassing thought for many adults having to wear them over several months of treatment. But there may be an alternative: clear aligners, a succession of slightly different plastic trays usually worn in two-week intervals. Sequentially wearing each tray gradually moves the teeth to their desired positions.
Though not appropriate for all bite situations, clear aligners have a number of benefits when they can be used. They’re nearly invisible to others and can be removed for hygiene tasks or rare special occasions. What’s more, the orthodontist may attach a temporary prosthetic (false) tooth to the trays to camouflage the missing space during treatment.
There’s one other issue you may have to deal with: if your tooth loss was related to periodontal (gum) disease, the gums and underlying bone may be in poor condition. In fact, substantial bone loss could rule out an implant altogether. But we may be able to remedy both gum and bone deficiencies through grafting or plastic surgery. It may be possible to regenerate enough bone to support the implant; and surgically repairing your gums will help ensure the implant appears natural.
If you have problems like these, don’t give up on your restoration goal just yet. With some orthodontic and dental work ahead of time, we may still be able to make implants a reality for you.
Cosmetic and restorative dentistry is filled with a varied array of procedures, materials and techniques that can address any shortcoming with your smile. Whatever your condition, there’s a means to correct or enhance your smile.
The real question, though, is whether we’re both, patient and dentist, on the same page as to what’s best to enhance your smile. Dentists have a different perspective on smile outcomes than the average layperson. We’re clued into aspects like tooth alignment with facial features or gum-to-lip distance influenced by our professional training and experience. You, though, may see your smile in terms of other features that define beauty like mouth expressions or lip shape.
Bridging these differing points of view requires open and honest communication. Here are three considerations to make that happen.
Build trust between you and your dentist. It’s natural for us to have differing views on what constitutes proper smile aesthetics based on the perspectives previously mentioned. Working through those perspectives to arrive at a unified plan requires trust that both of us desire the same outcome: a beautiful smile you’re happy to display to the world.
“Seeing” your future smile can help ease your misgivings. It’s one thing to try to imagine a certain treatment outcome — it’s quite another to actually see it beforehand. And you can, through computer simulation that takes a picture of your current face and smile and then augments them digitally so you can see how your smile will appear after proposed treatment. It’s also possible in some cases for you to wear temporary or “provisional” restorations so that not only can you see how they look, but also how they feel and function in the mouth.
Understand what “type” of restoration patient you are. Although everyone is different, we can usually characterize patients and their expectations in two ways. Some patients are “perfect-minded” — they want restorations that offer the maximum symmetry, regularity and tooth brightness. Others are more “natural-minded” in that the changes they seek don’t drastically alter their natural appearance, but are just enough to look different and create a sense of character. Knowing what you really want — a drastic change or a subtle enhancement — will help you communicate your desires more clearly and help us design the treatment options that best fit your expectations.
If you would like more information on fostering communication between dentists and patients, 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 “Great Expectations.”