health}
your teeth
D e a t h , Ta x e s , a n d D e n t a l T r a u m a by Dr. John F. Miller DDS
Every other month, I have the opportunity to brainstorm on my next “dental” topic to discuss with the readers of 406 Woman Magazine. I focus on maintaining relevance and reader interest with the otherwise “unsexy” profession of dentistry. Now that I’ve got you two sentences deep, thanks for reading, and please see my previous articles at 406Woman.com. I recently had the unique opportunity to perform an aesthetic porcelain crown restoration on a tooth that had spent the better part of fifteen minutes in the murky depths of Whitefish Lake some years earlier during the patient’s teenage years. While swimming with some friends and family, the patient was struck by a knee board causing the complete avulsion (loss) of his front left incisor. The patient’s father had the wherewithal and persistence to perform multiple dives to the 50
bottom of the lake searching for the lost tooth. Upon eventual discovery of the tooth, the father replaced it in its God-given natural location in the patient’s maxillary jaw bone and visited the dentist immediately. The tooth was temporarily stabilized and ultimately a smile was saved. The above story demonstrates a parent educated in dental trauma protocol. As a dentist I see dental trauma routinely, and it has become clear to me that a refresher course will benefit our amazing Montana women and their families. So grab a refreshing beverage, get comfortable in your favorite chair and think of the teeth that will be saved. First, let me briefly describe the anatomy of the human tooth. The outer shell of the tooth consists of approximately 1 to 2 millimeters of hard enamel; the hardest tissue in the human body. Beneath the enamel is a yellowish layer
called the dentin. and in the middle of it all is a chamber housing called the pulp, or the nerve and blood supply of the tooth. All of these layers mimic the outer anatomy of their respective teeth much like Russian nesting dolls. Below the gumline, the enamel and dentin layers converge into the root composed of a tissue called cementum. Fractures: A tooth fracture that does not involve the pulp is categorized as a Uncomplicated Tooth Fracture and is easily restored or contoured by your dentist depending on the extent of tooth loss. Also, within the uncomplicated tooth fracture category are Infractions, or fractures that are visible but do not result in the loss of tooth structure. It probably goes without saying, but tooth fractures that involve the pulp of the tooth and are considered Complicated Tooth Fractures. These fractures require immediate dental inter-
vention and will require some form of pulp therapy. Luxation: If following dental trauma, the tooth is tender to touch, has increased mobility (can be wiggled; is loose), or is no longer in its natural position (displacement), the tooth has suffered trauma referred to as Luxation. If a tooth is only tender to touch without displacement or increased mobility, then it has sustained a type of luxation known as Concussion. If the tooth is not displaced but has increased mobility and is bleeding around the gums, then it has sustained Subluxation. More severe luxative injuries involve the tooth being displaced from it’s natural position in any direction: up (intrusive), down (extrusive), front or back (lateral), etc. If the force is severe enough (like, let’s say a hockey stick to the mouth) the result will be a complete loss of the tooth or Avulsion.