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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. Joel Hartjes and Dr. Jon Szewczyk 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. Joel Hartjes and Dr. Jon Szewczyk 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. Joel Hartjes and Dr. Jon Szewczyk 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. Joel Hartjes and Dr. Jon Szewczyk 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 Middleton, WI office, it might be possible to make that loss only a temporary one.

Why does gum disease develop? Our mouths are home to bacteria, which form a film called plaque. Plaque sticks to the surfaces of our teeth, at the gumline, and can even grow below the gumline. And this bacterial growth leads to inflammation and gum disease.

When the disease progresses, the gums gradually pull away from the teeth leaving pockets which can be home to infection. Toxins can attack the bone structures and connective tissue, which support our teeth. Left untreated, periodontal disease can lead to serious infection and even tooth loss.

Because we are dealing with bacteria, it makes sense that antibiotics are one way to combat gum disease. Depending on the condition of your gums, we might suggest one of the following treatments:

• Mouthwashes—there are mouthwashes available with a prescription that are stronger than over-the-counter antibiotic formulas, and can be used after brushing and flossing.
• Topical Ointments—These ointments or gels are applied directly to the gums, most often used for mild forms of the disease.
• Time-release Treatments—If there is severe inflammation in a pocket, we might place a biodegradable powder, chip, or gel containing antibiotics directly in the affected area. These minute methods release antibiotics over a period of time as they dissolve.
• Pills and Capsules—For more serious periodontal disease, you could be prescribed an oral antibiotic. Take in pill or capsule form as recommended, and always finish the entire prescription.

Talk to Dr. Joel Hartjes and Dr. Jon Szewczyk at our Middleton, WI office before beginning a course of antibiotics. It’s important to know if you have any allergies to medications, what to look for if you might have an allergy you didn’t know about, if you are pregnant or breast-feeding, or if you have any health concerns that would prohibit antibiotic use. Talk to us about possible side effects and how to use the medication most successfully. With proper treatment, we can treat gum disease as quickly and effectively as possible, and provide advice on maintaining a periodontal routine that will keep your gums and teeth healthy for years to come.

Also known as onchophagia, the habit of nail biting is one of the so-called “nervous habits” that can be triggered by stress, excitement, or boredom. Approximately half of all kids between the ages of ten and 18 have been nail biters at one time or another. Experts say that about 30 percent of children and 15 percent of adults are nail biters, however most people stop chewing their nails by the time they turn 30.

Here are four dental and general reasons to stop biting your nails:

1. It’s unsanitary: Your nails harbor bacteria and germs, and are almost twice as dirty as fingers. What’s more, swallowing dirty nails can lead to stomach problems.

2. It wears down your teeth: Gnawing your nails can put added stress on your pearly whites, which can lead to crooked teeth.

3. It can delay your orthodontic treatment: For those of our patients wearing braces, nail biting puts additional pressure on teeth and weakens roots.

4. It can cost you, literally: It has been estimated that up to $4,000 in extra dental bills can build up over a lifetime.

Dr. Joel Hartjes and Dr. Jon Szewczyk and our team recommend the following to kick your nail biting habit:

• Keep your nails trimmed short; you’ll have less of a nail to bite.
• Coat your nails with a bitter-tasting nail polish.
• Ask us about obtaining a mouthguard, which can help prevent nail biting.
• Put a rubber band around your wrist and snap it whenever you get the urge to gnaw on your nails.
• Think about when and why you chew your nails. Whether you are nervous or just bored, understanding the triggers can help you find a solution and stop the habit.
• If you can’t stop, behavioral therapy may be an effective option to stop nail biting. Ask Dr. Joel Hartjes and Dr. Jon Szewczyk and our team for a recommendation.

A lot of changes occur in a woman's body during pregnancy. Hormone fluctuations are responsible for many of those changes, including the need for additional attention to the teeth and gums. Women who are expecting are at an increased risk for oral health complications, including gingivitis and tooth decay, which can lead to irreversible damage. Fortunately, there are steps pregnant women can take to keep their teeth and gums in optimal health from the first trimester to delivery day. Today, Dr. Joel Hartjes and Dr. Jon Szewczyk and our team at hartstone dental thought we would share them.

At-home dental care

At-home dental care should not vary much from what you did prior to pregnancy. The American Dental Association recommends brushing at a minimum of twice per day using fluoridated toothpaste. Follow up with floss to keep bacteria from accumulating in hard-to-reach spaces.

Dental checkups

It is safe and recommended to continue visiting Dr. Joel Hartjes and Dr. Jon Szewczyk for routine dental checkups and cleanings during pregnancy. However, it is very important to inform Dr. Joel Hartjes and Dr. Jon Szewczyk about an existing pregnancy. Special steps must be taken to protect pregnant women from certain medications or X-ray radiation that could be harmful to a growing baby. On the other hand, avoiding teeth cleanings during pregnancy can lead to serious consequences, including advanced tooth decay and infection.

Food and cravings

It is no secret that pregnancy can cause a woman to crave specific foods. Sugary treats like candy, cookies, or sodas may satisfy a sweet tooth, but they can also cause serious dental problems when consumed frequently or without brushing afterward. Trade out these treats for naturally sweet fruits when possible, and never forget to brush and floss thoroughly after eating sugar-filled foods.

Signs of complications

It is important to know and recognize the signs of oral health problems during pregnancy; an early diagnosis usually translates to an easier, less-invasive treatment. Symptoms of potential problems include gums that easily bleed or are swollen, reddened, or painful. These are symptoms of gingivitis, which can lead to a receding gum line and tooth loss if left untreated.

Call our Middleton, WI office if you experience any of these symptoms or pain in a tooth, loss of a tooth, a broken tooth, or bad breath that does not go away with brushing.