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Posts for: December, 2019

By Dr. Marvin Ernst General and Cosmetic Dentistry
December 26, 2019
Category: Oral Health
NHLIronManKeithYandleSuffersDentalTraumaonIce

Professional Hockey player Keith Yandle is the current NHL “iron man”—that is, he has earned the distinction of playing in the most consecutive games. On November 23, Yandle was in the first period of his 820th consecutive game when a flying puck knocked out or broke nine of his front teeth. He returned third period to play the rest of the game, reinforcing hockey players’ reputation for toughness. Since talking was uncomfortable, he texted sportswriter George Richards the following day: “Skating around with exposed roots in your mouth is not the best.”

We agree with Yandle wholeheartedly. What we don’t agree with is waiting even one day to seek treatment after serious dental trauma. It was only on the following day that Yandle went to the dentist. And after not missing a game in over 10 years, Yandle wasn’t going to let a hiccup like losing, breaking or cracking nearly a third of his teeth interfere with his iron man streak. He was back on the ice later that day to play his 821st game.

As dentists, we don’t award points for toughing it out. If anything, we give points for saving teeth—and that means getting to the dentist as soon as possible after suffering dental trauma and following these tips:

  • If a tooth is knocked loose or pushed deeper into the socket, don’t force the tooth back into position.
  • If you crack a tooth, rinse your mouth but don’t wiggle the tooth or bite down on it.
  • If you chip or break a tooth, save the tooth fragment and store it in milk or saliva. You can keep it against the inside of your cheek (not recommend for small children who are at greater risk of swallowing the tooth).
  • If the entire tooth comes out, pick up the tooth without touching the root end. Gently rinse it off and store it in milk or saliva. You can try to push the tooth back into the socket yourself, but many people feel uneasy about doing this. The important thing is to not let the tooth dry out and to contact us immediately. Go to the hospital if you cannot get to the dental office.

Although keeping natural teeth for life is our goal, sometimes the unexpected happens. If a tooth cannot be saved after injury or if a damaged tooth must be extracted, there are excellent tooth replacement options available. With today’s advanced dental implant technology, it is possible to have replacement teeth that are indistinguishable from your natural teeth—in terms of both look and function.

And always wear a mouthguard when playing contact sports! A custom mouthguard absorbs some of the forces of impact to help protect you against severe dental injury.

If you would like more information about how to protect against or treat dental trauma or about replacing teeth with dental implants, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Dental Implants: A Tooth-Replacement Method That Rarely Fails” and “The Field-Side Guide to Dental Injuries.”


By Dr. Marvin Ernst General and Cosmetic Dentistry
December 16, 2019
Category: Oral Health
Tags: dental injuries  
FollowTheseHolidayToyTipsforYourKidstoAvoidDentalInjuries

The holidays draw families together like no other season as loved ones gather from near and far to eat, drink and be merry—and exchange gifts. For the little kids that means toys (and sometimes for the big “kids” too!). Unfortunately, a toy meant to delight children could instead cause them harm, including injuries to their teeth and gums.

Be selective, then, when giving toys to the special children in your life this holiday season. Here are a few tips to remember to help protect their teeth and gums from injury.

Avoid toys with small parts. Given infants’ and toddlers’ propensity to put objects in their mouth, try to avoid choosing toys with small parts. While the main concern with smaller toys is the risk for choking, small, hard objects in the mouth could also cause dental damage. The danger is especially acute if a child falls while a toy or similar object is in their mouth.

Watch out for hard, sharp-edged toys. Younger children especially like to bite and gnaw on things. It’s prudent, then, to stay away from hard plastic toys or those with sharp points or edges—these could chip teeth or cut into the gums. Instead, look for toys made of more pliable plastic or fabric, and with rounder surfaces. When in doubt, look for labeling on packaging that indicates the appropriate ages for a particular toy.

Discard damaged toys. With your kids’ toy boxes brimming over with new holiday treasures, it’s a good time to do a safety inventory of their older toys. Besides those they’ve outgrown, look for toys that may have been damaged or broken. Although initially they may have been safe, toys in poor condition might pose many of the dangers to teeth and gums we’ve previously mentioned. Damaged toys should be either repaired or discarded.

Supervise their playtime. You might also want to keep a watchful eye out as your kids play with their new toys. While they do need their own time to be imaginative during play, children could put their toys to uses not intended for them, increasing the risk of injury. A bit of gentle supervision is a good idea to prevent unintended—and unwelcome—consequences.

The holidays are a magical time for all of us, but especially for children. Follow these holiday toy tips to prevent dental injuries that could ruin your family fun.

If you would like more information about protecting your child’s dental health, please contact us or schedule a consultation.


By Dr. Marvin Ernst General and Cosmetic Dentistry
December 06, 2019
Category: Oral Health
Tags: osteoporosis  
CertainOsteoporosisDrugsCouldPoseaFutureRisktoYourDentalHealth

Osteoporosis is a major health condition affecting millions of people, mostly women over 50. The disease weakens bone strength to the point that a minor fall or even coughing can result in broken bones. And, in an effort to treat it, some patients might find themselves at higher risk of complications during invasive dental procedures.

Over the years a number of drugs have been used to slow the disease’s progression and help the bone resist fracturing. Two of the most common kinds are bisphosphonates (Fosamax™) and RANKL inhibitors (Prolia™). They work by eliminating certain bone cells called osteoclasts, which normally break down and eliminate older bone cells to make way for newer cells created by osteoblasts.

By reducing the osteoclast cells, older bone cells live longer, which can reduce the weakening of the bone short-term. But these older cells, which normally wouldn’t survive as long, tend to become brittle and fragile after a few years of taking these drugs.

This may even cause the bone itself to begin dying, a relatively rare condition called osteonecrosis. Besides the femur in the leg, the bone most susceptible to osteonecrosis is the jawbone. This could create complications during oral procedures like jaw surgery or tooth extractions.

For this reason, doctors recommend reevaluating the need for these types of medications after 3-5 years. Dentists further recommend, in conjunction with the physician treating osteoporosis, that a patient take a “drug holiday” from either of these two medications for several months before and after any planned oral surgery or invasive dental procedure.

If you have osteoporosis, you may also want to consider alternatives to bisphosphonates and RANKL inhibitors. New drugs like raloxifene (which may also decrease the risk of breast cancer) and teriparatide work differently than the two more common drugs and may avoid their side effects. Taking supplements of Vitamin D and calcium may also improve bone health. If your physician still recommends bisphosphonates, you might discuss newer versions of the drugs that pose less risk of osteonecrosis.

Managing osteoporosis is often a balancing act between alleviating symptoms of the disease and protecting other aspects of your health. Finding that balance may help you avoid future problems, especially to your dental health.

If you would like more information on osteoporosis and dental care, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Osteoporosis Drugs & Dental Treatment.”




I. Marvin Ernst DDS, PA

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