Dr. Doering's Blog

Posts for: March, 2017

Blog #2--Addendum

 

If once daily you have thoroughly cleaned the gumlines surrounding each of your teeth but missed most of the remaining enamel surfaces you will have succeeded. Alternately, if the reverse is the result, you will have failed miserably. Reason—all periodontal problems which result in damage to gums, connective tissue and bone support begin at the gumline. Because the enamel is a fraction of a millimeter thin at the gumline, compared with several millimeters thick on the functional surfaces, many carious lesions (decay) begin at or near the gumline. Also sensitivity to various stimuli is traceable to this same region. Usually later in the aging process, the root surfaces that can be exposed because of natural recession or incorrect brushing, toothbrush bristles that are too stiff or both often lead to a restart of the decay process. See blog on xerostomia and importance of anatomic accuracy when extensive repair work in needed.

 

Because of the importance of the above, you will receive a new toothbrush whose unique design aids all of us in succeeding in this important region. At your next visit we will provide a demonstration as to how to beneift from its unique design.


Avulsed tooth (knocked out but intact)

 

Our expectation—that someone who has read the following instructions will be present when this occurs. More likely when spectating at a childrens basketball, soccer, baseball or other type of team sport where headgear isn't usually worn.

  1. Take charge/find the tooth/ instruct all others to stay away.

  2. Carefully pick the tooth up by grasping only the crown—enamel. Beware, saliva will make the crown slippery. Hold the tooth vertically—root up, crown down.

  3. Carefully inspect all root surfaces to verify no soil is attached.

  4. If soil is visible, rinse off with bottled water. Saliva from the child, saline, distilled water or skim milk are better choices but access is time consuming. Total time out of the socket is inversely proportional to overall success. The small tags of connective tissue seen on the root surface will survive if tooth out of socket time is very short.

  5. Push the root firmly into the socket, without regard to proper rotation. The child will be in early stages of shock and will not suffer significant pain during replantation.

  6. Parent, guardian or possibly the child must stabilize the tooth en-route to their dental office.

  7. Dentist should verify rotation without removing the tooth and then fabricate a stabilization system, as well as checking condition of surrounding bone and gum tissue.

  8. After initial healing has taken place, endodontic tmt (root canal) will be needed. In case the tooth is mandibular (lower arch) the root is narrow from side to side and long from front to back, therefore requires more attention (can only fit 2 ways) when replanting.

 


There is no physical malady that is not benefited by physical activity or exercise. There is no oral problem that is aided by neglecting your oral hygiene.


On the Important Task of Oral Hygiene/ Instructions:

 

First of all and very importantly:

Never multi-task with a toothbrush in your mouth (walking around, answering phone etc.). The toothbrush may drive into the rear of the oral and pharygeal area and can result in serious damage...

 

1. Rinse vigorously with warm water after each meal & before brushing until all particles have been removed (Check sink surface)*

2. Floss as demonstrated by yours truly.

3. Clean behind all four distal (back) teeth and through open contacts with gauze.

4. Clean dorsum (top) of tongue with gauze or appropriate scraper.

5. Brush as demonstrated with Colgate Enamel Health, Sensodyne Proenamel or other recommended paste.

6. Swish residual toothpaste as if it were mouthwash.

7. After removing toothpaste foam – rinse with Green Label Biotene for at least two minutes. Alternate: Act (If caries vulnerable)

 

Welcome to a very healthy mouth and longer life!

 

*Procedure becomes more important as we age and our risk for dental decay increases.


March 14, 2017
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This is the location of our office. It was designed in 1893 by Cass Gilbert. One of five commerical buildings which he designed in St. Paul, it is located in Lowertown which has been designated a National Historical District. It was beautifully restored in 1986 and connected with the skyway at that time.