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We do our best to plan for our health. We eat right, we exercise, we see our doctors and dentists for regular checkups. But despite our best efforts, we can’t plan for accidents. A bike rider’s encounter with a pothole can mean a broken jaw. A clumsy elbow knocks out a basketball player’s tooth. A car collision leaves the driver with fractured facial bones and lacerations.

These are all very different injuries, but they are all considered facial trauma. When you are the victim of an accident, it’s always important to get the best treatment as quickly as possible. That’s why, if you should ever find yourself in the emergency room with facial trauma, it’s a very good idea to ask for a consultation with an oral and maxillofacial surgeon like Dr. Theodotou.

Oral and maxillofacial surgeons are trained specifically in the treatment of facial traumas. They have a minimum of four years of surgical education in a hospital-based residency program. They train with medical residents, and focus on studies in general surgery, anesthesiology, internal medicine, plastic surgery, and otolaryngology (the study of the ear, nose, and throat), among other fields of specialty.

Because their training is centered on the face, mouth, and jaw, these surgeons are experts in diagnosing and treating the complex interrelationship of these structures. Let’s look at our unfortunate cyclist, for example.

A broken jaw involves bone, muscle, ligaments, and teeth. Bones need to fit back together properly; the joint that connects the jawbones needs to function smoothly; and not just the jaw, but the teeth need to be back in alignment. Because they know just how these structures must work together, oral surgeons are experts in restoring function after facial trauma.

But treating facial trauma involves more than restoring functionality. Oral and maxillofacial surgeons are also concerned with restoring the patient’s appearance for both physical and psychological healing. Oral surgeons are extensively trained in techniques to reduce scarring and to maintain the balance and symmetry of facial features.

If you suffer facial trauma, an oral and maxillofacial surgeon has the specific knowledge and training to provide you with the very best treatment for your injuries. Oral surgeons are also, because of their wide-ranging experience, able to discover even difficult-to-detect injuries, putting you on the fastest track to recovery. Their medical expertise includes the treatment of:

• Injuries to the teeth and surrounding bone and tissue

An injury to the mouth can lead to a lost or displaced tooth and damage to the bones and tissues surrounding it.

If a tooth is knocked out, reimplantation can be successful if it takes place promptly—after 30 to 60 minutes, the odds of successful reimplantation go down. Oral surgeons are also trained to discover and treat any injuries or fractures to the alveolar bone which contains the tooth sockets.

• Bone injuries

An accident can cause broken or fractured bones anywhere on the face. Oral and maxillary surgeons work with bones in the upper and lower jaws, around the eyes and nose, and in the cheeks and forehead. Just like a broken arm, fractured facial bones must be put back in place and stabilized. Unlike a broken arm, injuries to the facial bones cannot be treated with a plaster or fiberglass cast.

Depending on the nature of the fracture, treatment can involve letting the bones “rest” to heal in place, or placing screws and plates or wiring to keep the bones in their proper positions while they heal. Your surgeon will know if your injuries should be treated surgically or non-surgically, and whether reconstructive surgery might be necessary.

• Soft tissue and special tissue injuries

Accidents can damage more than tooth and bone. When facial lacerations occur, an oral surgeon is skilled at making sure that any necessary suturing is done with an eye toward the best cosmetic outcome. Intra-oral lacerations might mean not only attention to delicate gum tissue, but treatment of the salivary glands and ducts. Facial trauma can also affect the nerves around the eyes, face, and mouth, which require expert diagnosis and treatment in case of injury.

You can’t plan for facial trauma, but you can make sure to involve Dr. Theodotou as possible. If you or a family member suffers a facial injury, don’t be reluctant to ask for a consultation at our Pooler office as part of your treatment.

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 your dentist 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.

Often, dental or bone injuries are best treated by an oral surgeon. Oral and maxillofacial surgeons are the specialists in facial trauma, with years of surgical training and experience in the diagnosis and treatment of traumatic injuries. Any time surgery is recommended for bone or tooth trauma, ask for a referral to 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.

If the root, nerves, and blood vessels are still intact, the tooth can be placed back in its socket, and then anchored 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 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.

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 your dentist 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 your dentist a call.

What to do if you have a loose tooth?

• Call your dentist 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 is often best performed by an oral surgeon. Dr. Theodotou 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, give our Pooler office a call. 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 and confident smile? That’s a reason to celebrate!

Here is some surprising yet worthwhile advice you might be hearing for the first time: Brushing after a meal can be incredibly bad for your teeth if you do it after eating certain foods.

Enamel is an extremely hard mineral on the exterior of each of your teeth. It’s actually the hardest substance in the human body: It’s even stronger than your bones! Its only weakness is that acids in the food we eat can easily destroy enamel.

Healthy teeth thrive in an environment that has the proper pH balance. That ensures your mouth doesn’t start the process of demineralization. That’s what happens when alkaline turns into acid, which attacks and softens the enamel on the surface of your teeth. Pores and fissures form, and that’s when the harmful bacteria go to work.

Our mouth’s pH level fluctuates depending on what we eat throughout the day. Examples of the most common highly acidic foods include citrus fruits, soda, and sugary foods. Highly acidic foods tip the balance of pH in your mouth from a healthy alkaline to a dangerous acid.

Can brushing your teeth immediately after a meal lead to even more damage? The answer is yes!

Eating highly acidic foods causes your teeth to be more susceptible. If you brush your teeth when they have been weakened by acids, even more destruction can happen to your enamel. Your toothbrush’s bristles will actually wear away some of your enamel. So it’s healthier to wait at least an hour after eating or snacking to brush.

Good preventive measures to take instead of brushing after you eat include:

• Rinsing or drinking water
• Chewing sugarless gum
• Consuming dairy or non-acidic foods to conclude your meal

These practices help produce saliva, which in turn restores a healthy pH level in your mouth and coats the teeth with minerals they need.

Once you’ve allowed time for your mouth to be restored to a healthy pH level, you may brush your teeth as you normally would. Keep in mind that acidic foods can weaken the enamel on your teeth and take the right measures to prevent spiking pH levels.

Most important, don’t forget to wait to brush at least one hour after you eat!

Still have questions? Call our Pooler office and schedule an appointment with Dr. Theodotou.

Dr. Theodotou and our team at Oral and Maxillofacial Surgery of Coastal Georgia get this question a lot. Wisdom teeth are the last teeth to come in, once young people get their adult teeth. Because they are the last teeth to break through the gums, they are often called the third molars. There are four wisdom teeth: two on each side of the top and bottom of the mouth.

There is no hard-and-fast rule that says everyone must have the wisdom teeth removed. There are certain situations in which they either cause problems directly, or create a situation where there is a greater likelihood problems will arise eventually.

Impacted wisdom teeth

If Dr. Theodotou and our team say you have a soft tissue impaction, it means your wisdom tooth is covered by gum tissue that is preventing it from erupting — most likely because your mouth is too small to provide the tooth with the room it needs to emerge.

The term “partial bony impaction” means that gum tissue is covering the wisdom tooth, but part of the jaw bone is also covering it, in which case there is no room in your mouth for the tooth to erupt. The opposite end of this spectrum is a complete bony impaction, where the wisdom tooth is completely covered by gum tissue and the jawbone, which prevent it from ever erupting.

The importance of removing impacted wisdom teeth

Dentists often want to remove impacted wisdom teeth because of the likelihood that they will cause problems, or because a problem already exists. One such problem is pericoronitis, an acute abscess that affects partially impacted wisdom teeth. Food, bacteria, and other mouth debris can become lodged under the gum flap that covers the wisdom tooth, which prevents it from erupting. Pericoronitis symptoms include pain, swelling, and the presence of an abscess.

Regular dental checkups will enable your dentist to keep an eye on your wisdom teeth, especially if they have some type of impaction. Dr. Theodotou and our team at Oral and Maxillofacial Surgery of Coastal Georgia typically recommend removal of impacted wisdom teeth because of the likelihood that severe infections such as pericoronitis will develop.

If you have any questions about wisdom teeth, or if you would like to schedule an appointment with Dr. Theodotou, please give us a call at our convenient Pooler office!