Archive for the ‘Rehabilitation’ Category

The Chao Pinhole Surgical Technique (TM)

Isn’t this cool?

Well, if you’re the patient getting operated on, maybe you don’t think it’s so cool. Unless you’re the rare exception who likes needles in your gums.

But you should be excited, because this technique will allow your gums to be shaped with minimal risk, pain, and down-time. Its inherently minimally invasive and low-maintenance. There is no cutting or suturing, and healing is quick.

This technique was developed fairly recently by a man named Dr. Chao, and it is taking off internationally as the preferred method of gum shaping after periodontal or gingival treatment.

Note that this is solely meant to restore the gum line for the purpose of¬†aesthetics and functionality. It is not gum disease treatment, and it must be done in a disease-free mouth. So this is something I’d do after my patient has successfully undergone therapy for gum disease and only needs the gums to shrink back up around the teeth.

It sure beats the traditional method, however, of grafting gum tissue from another area of the mouth.

Dr. Sperbeck, West Los Angeles


Traumatic Dental Injuries: Other Injuries and Further Treatment

Besides fracturing immature adult teeth, the aforementioned dislodging or knocking out completely are some things that young people have to endure sometimes, unfortunately. However, modern dentistry has so much more to offer now than it ever did, thanks to science, technology and really, really smart people; so the level of treatment, restoration, or therapy only depends on the severity of damage done. The good news is that something can always be done.

If a young adult tooth were to be minorly dislodged (which means moved out of its natural position, remember?), extensive treatment may not even be necessary. The tooth may be only monitored over a period of time, possibly with minor adjustments made here and there, to ensure it continues to grow and develop normally. A tooth severely dislodged, surgery may have to be performed to restore stability and strength. In both of these cases, though, the tooth’s natural potential for strength will never be reached because of the injury, no matter what kind of treatment is performed.

If this immature tooth has been knocked out completely, if it can be put back into its socket and stabilized within one hour and watched closely by a dentist for a few weeks, chances are good that it can be saved. Changes in the tooth’s appearance and feeling will be monitored as well, and if any signs of decay or infection arise, then measures — particularly apexification — may have to be taken to keep it alive and well. If the tooth has been out for longer than an hour, it has probably dried out and must be filled with medication, put back into the socket, and re-stabilized as a “dead” tooth.

In either of those cases, the tooth is likely to not last as long as the others, in which case other options (say, an implant) will have to be discussed with the endodontist.

Dr. Sperbeck, West Los Angeles

Traumatic Dental Injuries: Root Fractures

The definition of a root fracture is exactly that — a fractured root.

In the tooth, of course.

Root fractures are horizontal cracks near the root of your tooth, occurring beneath the gum line (therefore requiring x-rays to find… when telltale pain and wiggly teeth first bring you to the dentist). The location of the fracture in relation to the ends of the tooth, the tip of the root (the apex) or the tips of the crown (the visible chewing surface), determines the lasting strength and health left in the tooth. The closer the fracture is to the root tip, the better the chances of a successful healing are. But the closer the fracture is to the crown, chances are it will not successfully heal on its own. A splint is also designed for this type of injury, to be worn temporarily as the tooth heals (if, of course, the fracture is minor enough to be left alone). If the pulp inside the tooth is damaged, a root canal may be required to disinfect and seal off the problematic area.

Dr. Sperbeck, West Los Angeles

Traumatic Dental Injuries: Avulsed Teeth

An avulsed tooth means it has fallen out — or been knocked out — completely. Even though it has been separated from your mouth, the tooth can still be saved if you act quickly. Try not to touch the root part of the tooth when you pick it up, and use only water to rinse it off if it is dirty. You must see a dentist immediately to try and put it back into its socket. Until that time, the more moist you can keep the tooth (i.e. by keeping it in a glass of water or milk with a pinch of salt), the better your chances will be of saving the tooth. Otherwise, if the tooth becomes infected or dies, an artificial tooth will probably have to replace it.

If, however, your dentist was able to salvage your real tooth and put it back into your socket, and design a splint to hold it in place for a while as it heals and re-stabilizes in your mouth. A root canal may be required to avoid or eliminate infection. The length of time the tooth was out of your mouth and the way the tooth was preserved will influence the decisions made on how your treatment will be carried out.

Dr. Sperbeck, West Los Angeles

Traumatic Dental Injuries: Dislodged Teeth

To have a dislodged tooth means the tooth has been moved from its natural position. Either it may have been pushed further into its socket, in which case the tooth will look “shorter” than the rest around it; or it will have been pushed partially out of its socket, which means it will be hanging down further than the rest of your teeth. Both cases may cause extreme discomfort and pain, and a trip to the dentist or endodontist is required to reposition and re-stabilize the tooth. Depending on whether the tooth’s pulp is affected, a root canal may or may not be needed. The dentist will closely monitor the progress of the tooth’s healing and the recovery process until regularity is restored.

Dr. Sperbeck, West Los Angeles