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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. Janna Spahr and Dr. Jeff Spahr 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. Janna Spahr and Dr. Jeff Spahr 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. Janna Spahr and Dr. Jeff Spahr 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. Janna Spahr and Dr. Jeff Spahr 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 Milford, NE office, it might be possible to make that loss only a temporary one.

A study conducted in Washington State in 2004 and another conducted in Madrid, Spain in 2012 both reported findings that support a direct relationship between parents’ dental fear and their child’s fear of the dentist.

The Washington study examined dental fear among 421 children ages 0.8 to 12.8 years old. They were patients at 21 different private pediatric dental practices in western Washington state. The Spanish study observed 183 children between the ages of seven and 12 as well as their parents.

The Washington study used responses from both parents and the Dental Sub-scale of the Child Fear Survey Schedule. The survey consisted of 15 questions, which invited answers based on the child’s level of fear. The scale was one to five: one meant the child wasn’t afraid at all, and five indicated he or she was terrified. The maximum possible points (based on the greatest fear) was 75.

Spanish researchers found a direct connection between parental dental fear levels and those among their kids. The most important new discovery from the Madrid study was that the greater the fear a father had of going to the dentist, the higher the level of fear among the other family members.

Parents, but especially fathers, who feared dental procedures appeared to pass those fears along to every member of the family. Parents can still have some control over fear levels in their children. It is best not to express your own concerns in front of kids; instead, explain why going to the dentist is important.

Dr. Janna Spahr and Dr. Jeff Spahr and our team work hard to make your child’s visit at our Milford, NE office as comfortable as possible. We understand some patients may be more fearful than others, and will do our best to help ease your child’s anxiety.

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. Janna Spahr and Dr. Jeff Spahr when you visit our Milford, NE office for the safest, most effective way to treat your child’s compromised tooth.

At Milford Dental Clinic, we know that hormones affect a woman's mood, but did you know they can also impact the health of a woman’s mouth? Women are susceptible to gum disease at different times in their lives, and research shows that hormonal highs and lows are part of the problem. According to studies, there are five situations in women’s lives during which hormone fluctuations make them more susceptible to oral health problems: puberty, their menstrual cycles, pregnancy, menopause, and birth control pill usage. So just what happens and how can you help protect your oral health? Dr. Janna Spahr and Dr. Jeff Spahr and our team have outlined the five hormonal situations and provided a few tips and tricks to fending off potential issues.

Puberty - The surge of hormone production that occurs during puberty can increase the blood flow to the gums and change the way gum tissue reacts to irritants in plaque. As a result, a woman's gums may bleed during the act of brushing and flossing.

Monthly menstruation cycle - Hormonal changes (especially the increase in progesterone) occur during a woman’s menstrual cycle. These changes can lead to red swollen gums, swollen salivary glands, canker sores, or bleeding gums.

Pregnancy - Hormone levels tend to fluctuate during pregnancy. As a result, women are at greater risk to develop a condition called gingivitis, the early form of gum disease. Dr. Janna Spahr and Dr. Jeff Spahr may recommend more frequent professional cleanings during your second or early third trimester to help reduce the chance of developing gingivitis. Please let us know if you are pregnant during your visit.

Menopause - Women are known to experience numerous oral changes as they age. These oral changes can include greater sensitivity to hot and cold foods and beverages, a burning sensation in your mouth, or dry mouth. Dry mouth, also known as xerostomia, can result in the development of tooth decay and gum disease because saliva is not available to moisten and cleanse the mouth. It is important to know that dry mouth can also result from many prescription and over-the-counter medications. The gradual loss in estrogen that occurs with menopause also puts older women at risk for loss of bone density, which can lead to tooth loss. Receding gums, which expose more of the tooth surface to potential tooth decay, can be a sign of bone loss in the jawbone.

Birth control pills - Some birth control pills contain progesterone, which increases the level of that hormone in the body. Women who take pills with progesterone may develop inflamed gum tissue due to the toxins produced from plaque. Be sure to tell us if you are taking an oral contraceptive during your visit.

To prevent gum disease, we recommend:

• Brushing your teeth at least twice a day with a toothpaste containing fluoride
• Flossing at least once a day
• Eating a well-balanced diet
• Avoiding sugary or starchy snacks

Dr. Janna Spahr and Dr. Jeff Spahr and our team at Milford Dental Clinic encourage you to visit our Milford, NE office and practice good oral health habits at home.