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In years past, it was often recommended that dental patients who had a history of heart problems or other conditions, such as joint implants, be given antibiotics before any dental work. This pre-treatment is called prophylaxis, based on the Greek words for “protecting beforehand.” Why would Dr. Gregory Weaver suggest this protection? It has to do with possible effects of oral bacteria on the rest of the body.

Our bodies are home to bacteria which are common in our mouths, but which can be dangerous elsewhere. If these oral bacteria get into the bloodstream, they can collect around the heart valve, the heart lining, or blood vessels. A rare, but often extremely serious, infection called infective endocarditis can result.

It is no longer recommended that every patient with a heart condition take antibiotics before dental procedures. Doctors worry about adverse effects from antibiotics or, more generally, that an overuse of antibiotics in the general population will lead to more strains of antibiotic-resistant bacteria.

There are some patients, however, who are at a higher risk of developing infective endocarditis, and who should always use preventative antibiotics. Generally, premedication is advised if you have one of these risk factors:

• A history of infective endocarditis
• Certain congenital heart conditions (heart conditions present since birth)
• An artificial heart valve
• A heart transplant

Your cardiologist will know if prophylaxis is advisable, and if you are taking any drugs which could interact with antibiotics. Always talk to your doctor about any dental procedures you are planning, particularly if they are invasive procedures such as gum surgery or extractions.

If you believe you would benefit from antibiotics before dental treatment at our Raleigh, NC office, the most important first step is to talk with your doctors. We are trained to know which pre-existing health conditions call for prophylaxis, which dental procedures require them, which antibiotics to use, and when to take them. Tell us about any health conditions you have, especially cardiac or vascular issues, and any medication allergies. Working with you and your doctor to protect your health is our first priority, and having a complete picture of your medical health will let us know if antibiotic prophylaxis is right for you.

When we were small, a loose tooth wasn’t a reason to be worried. On the contrary! It was a time to celebrate: A permanent tooth on the way. A sign that you were growing up. Perhaps even a lucrative visit from the Tooth Fairy. Losing a baby tooth had quite a few benefits.

Now that we’re grown, no such benefits are in store for us, because a lost adult tooth is gone for good. That’s why any time you notice a loose tooth you need to call Dr. Gregory Weaver immediately. With prompt dental care, that tooth might be saved.

But first, a word about how our teeth stay firmly rooted in the jaw.

• The visible part (crown) of a tooth is protected by a layer of enamel. The root below is covered with a protective layer called cementum.
• There is a socket for each tooth in the alveolar bone of the jaw, where each root is firmly attached within the socket by the periodontal ligament which surrounds it.
• This ligament is made up of connective tissue, which attaches both to the cementum covering the root and to the alveolar bone. It not only holds the tooth in place, it cushions the tooth from the daily pressure of biting and chewing.
• The gums surround the teeth and bone, protecting them from bacteria.

If the tooth, bone, ligament, or gums suffer damage, the result can be a loose tooth.

Treating a Loose Tooth

The treatment you receive will depend on the reason your tooth is loose. There are many situations which can lead to a loose tooth or teeth, and many treatment options available to you. Some of the common causes and potential treatments include:

• Accident or Trauma

If you have suffered a tooth or jaw injury as a result of an accident or trauma, it’s very important to see your dentist or doctor immediately. You should be carefully examined to determine whether there is damage to other teeth or the jaw. Serious tooth or jaw bone injury might require treatment by an oral surgeon.

In some cases of damage to the periodontal ligament or tooth, even if your tooth is loose or extruded (partially out of its socket), it can be stabilized in place so that the ligament and tissue around it has time to heal.

We’ll make sure the root, nerves, and blood vessels are still intact, position the tooth back in its socket, and then anchor it to the adjacent teeth with a flexible splint for several weeks. In the case of an alveolar or a root fracture, a rigid splint may be used.

Splinting gives the periodontal ligament and bone surrounding it time to heal while keeping your injured tooth from further displacement.

• Bite problems & Bruxism

Your teeth are designed to withstand a lot of pressure—in fact, in some ways, pressure is essential for healthy teeth and bone. The normal pressure of chewing and biting stimulates bone tissue in the jaw. When a tooth is lost, that stimulation is gone and the result is gradual bone loss in the area underneath the lost tooth.

But sometimes, the pressure exerted by a malocclusion (bad bite) or bruxism (tooth grinding) is too forceful. The connective tissue which holds the teeth in place is damaged by these forces, and loose teeth can be the result.

If you have a serious malocclusion, an orthodontist can provide the relief you need with braces or aligners. If your bite problem is caused by a tooth or teeth which are a bit too high, the enamel can be carefully contoured and reshaped. In some cases, splints, either temporary or permanent, can also be used to stabilize several adjacent teeth so that any biting or chewing force is spread over the section as a whole.

If you grind your teeth, a night guard can be custom fitted to provide relief from the pressures and impact of tooth clenching and grinding. This special kind of mouth guard is known as an occlusal splint.

• Osteoporosis

Osteoporosis causes a loss of bone density throughout the body. Studies suggest that this disease can affect bone in the jaw, leading to weaker bone and looser teeth. Your physician will provide your best medical alternatives, and be sure to let us now if you are taking medication for osteoporosis before we plan your dental treatment.

• Periodontal Disease

Gum disease is one of the major causes of loose—and lost—teeth. Early gum disease, called gingivitis, should be treated promptly to avoid a more serious condition called periodontitis. Periodontitis can cause the gums to pull away from the teeth, creating pockets for bacterial growth and infection. Left untreated, this infection results in connective tissue and bone loss.

If you have serious gum disease, we might suggest a visit to a periodontist, a specialist trained in the treatment of the gums, periodontal ligaments, and bone surrounding the teeth. Deep cleaning procedures such as scaling and root planing, topical and oral antibiotics, and oral surgeries such as flap surgery or bone and tissue grafting can help reverse the effects of periodontitis. Bone loss cannot be reversed, but a graft can replace lost bone and allow healthy tissue to regenerate.

• Pregnancy

Hormonal changes can cause the ligaments and bone around your teeth to loosen, which can lead to loose teeth. While this might be an alarming development, it’s generally a temporary condition. Talk to us about how to take care of your teeth and gums during your pregnancy.

Hormonal changes can also make your gums more vulnerable to irritation and infection. In fact, swollen and tender gums are often one of the first signs of pregnancy. That’s another reason it’s very important to keep up with dental hygiene during pregnancy. If your gums are red, swollen, bleeding, or tender, give us a call. A periodontist can be especially helpful if gum problems persist.

What to do if you have a loose tooth

• Call us immediately. Timely professional care can mean the difference between saving your tooth and losing it.
• Avoid wiggling the tooth. This could loosen it further.
• Protect your loose tooth. Eat soft foods, and try not to chew near the affected area. And while a liquid diet might sound like a good idea, no straws, please. Straws require suction, which can further dislodge your tooth.
• Keep the area clean, gently.

What to do if a tooth can’t be saved

Baby teeth become loose and fall out because the permanent teeth coming in erode the smaller roots holding them in place. That’s why it’s so easy for parents to help their child’s wiggly baby tooth find its way from mouth to Tooth Fairy.

Adult roots, however, involve alveolar bone, ligaments, blood vessels, and nerves, so an extraction really needs to be done by a professional. We will also examine you carefully to discover the reason for the tooth loss, and to prevent further damage with additional treatment as needed.

Finally, if you do lose a permanent tooth, there is still much that can be done to restore your smile. Modern implants are almost indistinguishable from natural teeth, and, what’s more, they function just like natural teeth to stimulate the bone beneath them.

If you have any worries about your teeth, contact our Raleigh, NC office. A loose tooth is never a cause for celebration, but, with proper dental care, a loose tooth doesn’t always lead to a lost tooth. Restoring a firm bite and a heathy, confident smile? That’s a reason to celebrate!

Young adults often have the reputation of not taking good care of themselves. You may feel invincible, and not realize how much your behaviors now can affect your health later in life. Oral health is one area that is easy to neglect now, but that can lead to serious financial and quality of life consequences later.

Follow a Good Oral Care Regimen

If you don’t already do so, it’s time to brush, floss, and rinse as Dr. Gregory Weaver taught you. Brush at least twice a day or after meals, and floss your teeth every day. If recommended, use mouthwash to kill germs in your mouth. If you are not able to brush your teeth after eating, swish water around in your mouth to remove the food from your teeth. Leaving carbohydrates in your mouth allows bacteria to ferment it and produce acid, which can destroy your tooth enamel and put you at risk for decay.

Visit Our Office Regularly

Young adulthood can be a challenging time when it comes to medical care. Your parents are no longer paying for your health insurance or taking you to your appointments. You may not worry much about getting regular cleanings and exams, especially if you’re paying for them yourself.

However, young adults have a lot to gain from visiting our Raleigh, NC office regularly. We can check for signs of problems and fix them early, which can save thousands of dollars and, ultimately, your teeth. These are some examples of what Dr. Gregory Weaver and our hygiene team can do for you.

• Get rid of plaque so it does not develop into tartar and cause periodontitis.
• Identify and fill small areas of tooth decay to prevent it from progressing.
• Examine your gums for signs of gingivitis, or early gum disease.

Consume a Tooth-Healthy Diet

A nutritious diet is not just for preventing heart disease and diabetes later in life. It also supports your teeth. Make sure to get plenty of calcium, such as from dairy products, canned fish, and leafy green vegetables to allow for strong teeth. Also, limit sticky foods and sugary sweets.

Baby teeth come with a built-in expiration date. That charming first smile is meant to make way for a healthy, beautiful adult smile. Unfortunately, before they are ready to make way for permanent teeth, primary teeth can be affected by decay, trauma, or infection—problems which can lead to damage to the pulp within the tooth. If your dentist tells you that your child’s tooth needs specialized endodontic treatment, is treatment really that much better for your child than losing a baby tooth prematurely?

Quite often, the answer is yes!

Baby teeth do much more than serve as temporary stand-ins for adult teeth. They are essential for:

• Biting and chewing—a full set of baby teeth helps your child develop proper chewing, which leads to healthy digestion. And chewing also helps build face and jaw muscles.
• Speech development—primary teeth help guide speech production and pronunciation.
• Spacing—a baby tooth serves as a place holder for the adult tooth waiting to arrive. If a primary tooth is lost too early, the remaining baby teeth may drift from their proper location. This, in turn, can cause overcrowding or misalignment of the permanent teeth when they do erupt.

Baby teeth, like adult teeth, contain living pulp tissue. The pulp chamber inside the crown (the visible part of the tooth) and the root canals (inside each root) hold nerves, blood vessels, and connective tissue. When the pulp is damaged by trauma or infected, a baby tooth can still be saved with endodontic treatment. Endodontic treatment in baby teeth can take two forms.

• “Vital” pulp is pulp that can be saved. Vital pulp therapy uses procedures to deal with damaged pulp inside the crown, or visible part, of the tooth. Pulp therapy can be used on teeth when only the top of the pulp has been affected by decay, limited exposure, infection, or trauma, but the root pulp remains healthy. Specific treatment will depend on the nature of the pulp injury, and a crown will usually be placed over the tooth after treatment to protect it.
• With non-vital pulp, your dentist will probably recommend a traditional root canal procedure. All of the pulp tissue will be removed from inside the crown and the roots, and the pulp chamber and root canals will then be cleaned, disinfected, shaped, and filled. Finally, because the treated tooth will be more fragile, a crown will be used to protect the tooth from further damage.

There can be good reasons for extracting a seriously damaged baby tooth, and there are situations where preserving the tooth is the best and healthiest option for your child. Discuss your options with Dr. Gregory Weaver when you visit our Raleigh, NC office for the safest, most effective way to treat your child’s compromised tooth.