My Blog

Posts for: January, 2020

By Dr. Nishi Vakharia, DDS
January 23, 2020
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. Nishi Vakharia, DDS
January 13, 2020
Category: Dental Procedures
StopBiteProblemsEarlyWithInterceptiveOrthodontics

Every year many parents learn their “tweenager” or teenager needs their bite corrected, often with specialized orthodontics. Imagine, though, if these families could go back in time to when their child’s poor bite was just developing to stop or slow it from forming.

Time travel may still be science fiction, but the approach suggested isn’t. It’s called interceptive orthodontics, a group of techniques and procedures performed during the early stages of jaw development. The focus is usually on getting abnormal jaw growth back on track, enough so that a poor bite won’t form.

The upper jaw, for example, may be growing too narrow, reducing the amount of available space for tooth eruption. If it isn’t corrected, teeth can erupt out of position. To correct it, an orthodontist places a palatal expander in the roof of the child’s mouth (palate). The appliance applies gentle pressure against the inside of the teeth, which stimulates the jaws to develop wider.

The expander works because of a separation in the bones at the center of the palate, which later fuse around puberty. The pressure applied from the expander keeps this gap slightly open; the body then continues to fill the widening expansion with bone, enough over time to widen the jaw. If you wait until puberty, the gap has already fused, and it would have to be reopened surgically to use this technique. Ideally, then, a palatal expander should be employed at a young age.

Not all interceptive techniques are this extensive—some, like a space maintainer, are quite simple. If a primary (baby) tooth is lost prematurely, teeth next to the empty space tend to drift into it and cause the intended permanent tooth to erupt out of place due to a lack of space. To prevent this an orthodontist places a small wire loop within the space to prevent other teeth from moving into it.

These are but two examples of the many methods for stopping or slowing a developing bite problem. To achieve the best outcome, they need to be well-timed. Be sure, then, to have your child undergo an orthodontic evaluation around age 6. If an interceptive orthodontic approach is needed, it could eliminate the need for more extensive—and expensive—treatment later.

If you would like more information on treatments to get ahead of bite problems, please contact us or schedule an appointment for a consultation.


By Dr. Nishi Vakharia, DDS
January 03, 2020
Category: Oral Health
3ThingsYouCanDotoHelpYourChildAvoidToothDecay

As a parent, you’re all about helping your kids grow up healthy. But there are some obstacles that can make that difficult. One in particular is tooth decay, which could interfere with their dental development.

A bacterial infection, tooth decay destroys dental tissue—and untreated it could lead to tooth loss. This could severely derail a child’s normal development, even if it’s one of their primary (“baby”) teeth. That’s why preventing tooth decay or treating it promptly when it occurs should be one of your top priorities for your child’s dental health.

Here are 3 things you can do to minimize your child’s risk of tooth decay.

Start oral hygiene early. Your best defense against tooth decay is to clean your child’s teeth daily of dental plaque, a thin film of bacteria and food particles that’s the main driver for dental disease. The best way to do this is with brushing and flossing, so begin performing these tasks with your child as soon as their teeth begin to appear. Oral hygiene is also important before their teeth come in—simply wipe your infant’s gums after nursing with a clean damp cloth to reduce bacteria in the mouth.

Start dental visits early. By age 1, most children already have quite a few teeth, making it the recommended time to schedule their first dental visit. Not only will this and subsequent visits support your plaque removal efforts, they also give your dentist an opportunity to catch any emerging dental issues. Early visits can also help get your kids used to seeing the dentist, reducing the chances they’ll develop dental visit anxiety later in life.

Avoid “baby bottle decay.” Sugar is one of decay-causing bacteria’s favorite food sources, so restricting your child’s intake of this carbohydrate can lower their decay risk. ┬áBesides limiting sugary snacks and sweets, be sure you do one more thing: eliminate sugar from the nighttime or naptime baby bottle. Parents often lay babies down to sleep with a bottle filled with sugary liquids like juice, milk or formula. Either avoid giving the bottle or make sure it only contains water.

If you would like more information on how to help your kids’ dental development stay on a healthy track, 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 “Top 10 Oral Health Tips for Children.”