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You use your mouthguard for sports, wear a nightguard if you grind your teeth, and never bite down on solid objects. But even with all the care in the world, accidents happen. If we break a leg, our bones can regenerate tissue and knit together over time. A cracked tooth, on the other hand, can only be repaired, but will not heal. The right treatment is essential to protect your injured tooth. If you suspect you have a fractured tooth, what should you do?

Sometimes you know right away when you’ve cracked a tooth. A fall off a bike, a blow to the face on the basketball court, a bite of something that turned out to be much harder than it should have been—the results can be instantly apparent. If you have a broken or chipped tooth, call our New York, NY office immediately. If you have lost a piece of your tooth, bring it in with you. Early treatment can not only restore the appearance of your tooth, but might prevent the possibility of infection or damage to the root and pulp.

Sometimes, a fractured tooth is an unwelcome surprise. It doesn’t take one specific incident to cause damage to a tooth. A crack or break can develop over time if you grind your teeth, have a large filling that has compromised a tooth, or have undergone a root canal procedure that has left the tooth brittle.  You might notice a crack or a missing piece of tooth, or experience pain while chewing or sensitivity to heat and cold. If you have any of these symptoms, call us. Once again, the earlier a tooth is treated, the better the outcome.

No matter how you discover an injury, immediate treatment by Dr. David Shipper and Dr. Howard Vogel is the best way to safeguard your healthy smile. Prompt treatment and restoration repair your smile cosmetically, and, in the case of more serious fractures, extend your tooth’s life, prevent further damage, and ward off potential infections of the gum and bone.

We have many options for restoring your damaged tooth, and our recommendations will depend on the type of injury your tooth has suffered.

• Chips

It is important to bring any broken piece of your tooth with you because sometimes the piece can be reattached. If that is not possible, a small chip might only require bonding with a tooth-colored resin. A veneer is an option for a larger chip, or where a translucent, natural appearance is important. If the chip is deep enough, and there is pulp damage, we might suggest a root canal and a crown.

• Broken Cusps

A lost cusp is a common result of injury, especially near a filling. If the pulp is unaffected, which is generally the case, a filling or crown can restore the appearance and function of the tooth.

• Cracks through the Tooth

A tooth cracked from the chewing surface to the root presents a more serious problem. If the crack has extended to the pulp, but remains above the gum line, a root canal and crown can preserve the tooth. If the crack extends below the gum line, however, extraction might be necessary. Early cracks will eventually extend below the gum line, so early treatment is essential.

A tooth can also fracture from the root up. Any crack in the root is a serious matter, and often is not discovered until infection has set in. Extraction is a common recommendation, although some specific cracks near the tip of the root might be treated with endodontic surgery.

• Split Tooth

Sometimes an untreated vertical crack can lead to a tooth split into two pieces. An endodontist can determine whether any portion of the tooth can be saved, although extraction is more likely.

If you injure your tooth, or have any symptoms of a tooth fracture, call us immediately. Whether you have suffered a chipped tooth, a broken cusp, crown or root fractures, or even a split tooth, prompt treatment is the best way to restore and protect your attractive and healthy smile.

It's a habit many people have and not only can it be annoying to the people around you, it can be detrimental to your dental health. Chewing ice is so common that it even has its own name, pagophagia. We're not talking about a slushy or shaved ice (although those artificially sugary treats should be avoided too!) but more like the hunks of ice rattling around in the bottom of your glass.

Ice chewing can be a sign of emotional problems like stress or obsessive-compulsive disorder, but it can also be a marker for iron deficiency anemia and other physical problems. Then again, some people just like to have something to chew on. For whatever reason you find yourself chewing on it, it's a habit you need to break.

Chewing on ice can cause:

• Chipped and cracked teeth
• Damaged enamel
• Sore jaw muscles
• Damage to dental work such as crowns, fillings, or other appliances

If chewing on ice is becoming a problem in your life, don’t hesitate to speak with Dr. David Shipper and Dr. Howard Vogel about it. But if you find yourself still wanting to chew on something, here are a few alternatives to ice:

• Baby carrots
• Celery sticks
• Sugar-free (xylitol) gum

We know you need to chill sometimes, but chomping down your entire glass of ice is not the way to do it. If you have any other questions on the topic, feel free to talk with a member of our New York, NY team. It may be beneficial in solving the issue and helping to remediate any damage to your teeth.

Many smokers believe that chewing tobacco is a safer alternative to smoking cigarettes. This simply isn't the case! In fact, smokeless tobacco can cause serious health concerns.

Smokeless tobacco comes in many forms and goes by many names: dip, snuff, snus, or simply chewing tobacco. Use of these products usually involves sucking or chewing on shredded or loose tobacco leaves, sometimes flavored, for a prolonged period. There are even products that emulate a dissolvable candy-like consistency which are made of compressed tobacco powder.

What are risks and smokeless tobacco?

Whichever form a tobacco product takes, the dangers of using or consuming them is very real. According to a 2007 study by the World Health Organization's International Agency for Research on Cancer, there are upwards of 28 cancer-causing chemicals in smokeless tobacco that are known to cause cancer. And these products are habit-forming just like any other tobacco product that contains nicotine. Using them will increase your risk for many serious diseases including but not limited to: cancer (especially oral and esophageal), gum and heart disease, cavities, and pre-cancerous mouth lesions.

At the end of the day, long-term use of smokeless tobacco can cause serious health issues. These products really take a toll on both your oral and overall health. They put a strain on your immune system and make it less capable of warding off infection and disease.

Dr. David Shipper and Dr. Howard Vogel and our team strongly advise you to stop using smokeless tobacco—or any kind of tobacco product—and not to pick up the habit if you aren't. There is no safe level of tobacco use, smokeless or otherwise.

Need to quit smoking or using smokeless tobacco products?

You can and should always talk to your doctor, healthcare practitioner, or Dr. David Shipper and Dr. Howard Vogel for help quitting. But there are many other resources available today for those who'd like to quit. The National Cancer Institute offers information, support (local and online), and tools to help smokers and smokeless tobacco users quit. They offer live online chat with cessation counselors Monday through Friday and even have a smartphone application available to help people who are serious about quitting.

You can take a look at their website at smokefree.gov or call them toll-free at 1–877–44U–QUIT (1-877-448-7848). There is also help available from your state's quit line at 1-800-QUIT-NOW (1-800-784-8669).

Make the best choice for your health and well-being; avoid the bad habit of tobacco products. If you have any questions about how tobacco related products affect your oral health and hygiene, please don't hesitate to ask one of our New York, NY staff members.

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 Dr. David Shipper and Dr. Howard Vogel 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. Serious tooth or jaw bone injury might require treatment by 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.

We’ll make sure the root, nerves, and blood vessels are still intact, position the tooth back in its socket, and then anchor it 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 have a serious malocclusion, an orthodontist can provide the relief you need with braces or aligners. If your bite problem is caused by a tooth or teeth which are a bit too high, the enamel can be carefully contoured and reshaped. In some cases, splints, either temporary or permanent, can also be used to stabilize several adjacent teeth so that any biting or chewing force is spread over the section as a whole.

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.

If you have serious gum disease, we might suggest a visit to a periodontist, a specialist trained in the treatment of the gums, periodontal ligaments, and bone surrounding the teeth. Deep cleaning procedures such as scaling and root planing, topical and oral antibiotics, and 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 us 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 us a call. A periodontist can be especially helpful if gum problems persist.

What to do if you have a loose tooth

• Call us 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 really needs to be done by a professional. We 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, contact our New York, NY office. 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, confident smile? That’s a reason to celebrate!