My Blog
By Joseph & Nina Zeigler, DMD, PC
November 20, 2018
Category: Oral Health
DentalInjuryIsJustaTemporarySetbackforBasketballStarKevinLove

The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.

In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?

The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.

Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.

So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”

Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.

If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”

By Joseph & Nina Zeigler, DMD, PC
November 10, 2018
Category: Oral Health
Tags: nutrition   sports drinks  
PracticeCautionwithEnergyorSportsDrinkstoProtectYourEnamel

Although energy and sports drinks have different purposes, they have one thing in common: they often contain added citric and other acids to improve taste and prolong shelf life. Their high acid content can harm tooth enamel.

Although enamel is the strongest substance in the body, acid can dissolve its mineral content. And although saliva neutralizes acid after eating or drinking and helps restore lost minerals to the enamel, it may not be able to keep up if the mouth remains acidic for a prolonged period of time.

That could happen with both beverage types. While energy drinks have higher acid levels than sports drinks, both are high compared with other beverages.

A recent laboratory experiment studied the two beverages’ effect on tooth enamel. The researchers submerged samples of enamel in six different beverage brands (three from each category) for fifteen minutes, and then in artificial saliva for two hours to simulate mouth conditions. They repeated this cycle four times a day for five days.

At the end of the experiment the enamel in the energy drinks lost on average 3.1 % of their structure, while the sports drink samples lost 1.5%. Although energy drinks appeared more destructive, the acid in both beverages caused enamel damage. Although there are other factors to consider in real life, the experiment results do raise concerns about both beverages’ effect on dental health.

You can, however, minimize the potential harm to your enamel from energy or sports drinks. First, try other beverage choices lower in acid; water, for example, is a natural hydrator and neutral in pH. Try to only drink energy or sports beverages at mealtimes when your saliva is most active. And after drinking, rinse your mouth out with water to dilute any remaining acid.

And although it sounds counterintuitive, wait about an hour to brush your teeth after drinking one of these beverages. Your enamel can be in a softened state before saliva can re-mineralize it, so brushing earlier could remove tiny amounts of enamel minerals.

Taking these steps with energy or sports beverages could help you reduce the chances for enamel erosion. Doing so may help you avoid unnecessary damage to your teeth and overall dental health.

If you would like more information on the effect of sports and energy drinks on dental health, 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 “Think Before You Drink.”

By Joseph & Nina Zeigler, DMD, PC
November 01, 2018
Category: Dental Procedures
Tags: crowns  

One of the best ways to cover up teeth that have undergone restorative procedures is using crowns. You dentists in Saint Louis, MO, Dr. Joseph Zeigler and Dr. Nina Zeigler, are more than happy to tell you more about crowns and their benefits.

More About Crowns

Crowns are cap-like porcelain dental restorations. Your Saint Louis dentist takes an impression of your teeth and sends them to a lab where custom crowns are made just for you. In the meantime though, you're given a temporary crown.

During restorative procedures, such as root canals, a significant amount of natural tooth is removed. This leaves the tooth susceptible to breakage, which is why a dental crown is placed over the tooth. The dental crown reinforces the tooth and allows it to withstand various degrees of pressure, meaning you can enjoy eating without the worry of ruining your tooth.

Here are some other procedures that use dental crowns:

  • Attaching bridges
  • Covering an existing filling that may be dislocated
  • Covering stained or discolored teeth
  • Covering dental implants

Taking Care of Your Crowns

  • Dental hygiene is crucial. You need to brush twice a day, at least, and floss before bed. Make sure to give special attention to the area around your dental crown by holding your brush at a 40-degree angle to get hard-to-reach areas.
     
  • Bruxism, when someone grinds their teeth, can reduce how long your crowns last as well. So make sure you find a solution for it with your dentist, like getting a mouth guard or splints.
     
  • Diet contributes to crowns longevity. Crowns can last a long time, so be sure to avoid biting into ice, eating, or drinking, sugary foods and drinks, like soda and candy.

For more information on dental crowns and what they can do for you, contact Drs. Joseph and Nina Zeigler in Saint Louis, MO, as soon as possible, by calling (314) 872-7590.

By Joseph & Nina Zeigler, DMD, PC
October 31, 2018
Category: Oral Health
Tags: loose teeth  
ThePerilsofaLoosePermanentTooth-andWhattodoAboutit

A loose baby tooth is normal and expected; a loose permanent tooth is quite another matter: it’s an advanced sign of disease that could lead to losing the tooth.

The reasons for its looseness may vary. You may have experienced “primary occlusal trauma,” in which the teeth have experienced a prolonged excessive biting force beyond their tolerance. This can be caused by habitual grinding or clenching the teeth.

You may have also experienced “secondary occlusal trauma”: although the biting forces are within normal ranges, the teeth still can’t handle the stress due to degraded bone support and gum tissue detachment. Clenching habits combined with weakened bone and gums will only accelerate and worsen the damage.

The most frequent cause in adults for loose teeth is secondary trauma from periodontal (gum) disease. Bacterial plaque built up on teeth from poor oral hygiene causes a chronic infection that eventually weakens gum attachment to the teeth. A loose tooth is a late sign of this damage.

Treatment for disease-based loose teeth has a twofold approach. First, we thoroughly clean the tooth, root and gum surfaces of all plaque and calculus (hardened plaque deposits) to reduce the infection and inflammation and restore tissue health. This is often accompanied by antibiotic treatments to reduce bacteria below the gum tissue.

For the loose teeth themselves, we may need to modify the forces against them while the gums and bone heal. One way to lessen the biting force on a tooth is to reshape its and the opposing tooth’s biting surfaces. For extensive looseness we can also splint the affected tooth or teeth with other teeth. Temporarily, we can apply splinting material to the outside of both the loose and stable teeth or cut a small channel into them and apply bonding material to join them. A permanent option is to crown both the affected teeth and nearby stable teeth and fuse the crowns together.

These and other stabilizing techniques, like occlusal night guards to reduce the effects of teeth grinding or orthodontic treatment, will help secure the teeth. Coupled with disease treatment and renewed dental care and hygiene practices, you may be able to keep that loose tooth from being lost.

If you would like more information on treating loose teeth, 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 “Treatment for Loose Teeth.”

By Joseph & Nina Zeigler, DMD, PC
October 21, 2018
Category: Dental Procedures
Tags: dental implants  
WhatYouShouldKnowAboutAntibioticTherapyBeforeImplantSurgery

Placing a dental implant within the jawbone requires a surgical procedure. For most people it’s a relatively minor affair, but for some with certain health conditions it might be otherwise. Because of their condition they might have an increased risk for a bacterial infection afterward that could interfere with the implant’s integration with the bone and lead to possible failure.

To lower this risk, dentists for many years have routinely prescribed an antibiotic for patients considered at high-risk for infection to take before their implant surgery. But there’s been a lively debate among health practitioners about the true necessity for this practice and whether it’s worth the possible side effects that can accompany taking antibiotics.

While the practice still continues, current guidelines now recommend it for fewer health conditions. The American Dental Association (ADA) together with the American Heart Association (AHA) now recommend antibiotics only for surgical patients who have prosthetic heart valves, a history of infective endocarditis, a heart transplant or certain congenital heart conditions.

But patients with prosthetic joint replacements, who were once included in the recommendation for pre-surgical antibiotics, are no longer in that category. Even so, some orthopedic surgeons continue to recommend it for their joint replacement patients out of concern that a post-surgical infection could adversely affect their replaced joints.

But while these areas of disagreement about pre-surgical antibiotics still continue, a consensus may be emerging about a possible “sweet spot” in administering the therapy. Evidence from recent studies indicates just a small dose of antibiotics administered an hour before surgery may be sufficient to reduce the risk of infection-related implant failure with only minimal risk of side effects from the drug.

Because pre-surgical antibiotic therapy can be a complicated matter, it’s best that you discuss with both the physician caring for your health condition and your dentist about whether you should undergo this option to reduce the infection risk with your own implant surgery. Still, if all the factors surrounding your health indicate it, this antibiotic therapy might help you avoid losing an implant to infection.

If you would like more information on antibiotics before implant surgery, 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 “Implants & Antibiotics: Lowering Risk of Implant Failure.”





This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.