Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
A deeper fracture can involve both the enamel and the dentin of a tooth. The tooth is still not displaced and the gums are not bleeding. These deeper fractures may be sensitive to cold temperature or food. Prolonged exposure of dentin to oral bacteria can cause the death of the inner pulp tissue. Death of pulp tissue can lead to serious tooth infection and abscess. Therefore, fractures involving the dentin should be treated promptly (within days of the injury). Treatment involves placing a sedative dressing over the exposed dentin, followed by a dental filling, a porcelain or gold crown, or a "cap" to protect the pulp of the tooth. A follow up
X-ray in three to six months may be needed to be sure that the pulp has not died.
If the fracture has already significantly injured the pulp, then treatment involves either extracting the dying tooth or performing a root canal procedure to prevent serious tooth infection. The root canal procedure is done to save the dying tooth from infection and extraction. This procedure involves removing all the dying pulp tissue and replacing it with an inert material in order to keep infection out.
What if I get my teeth knocked out?
The upper front permanent teeth are the most common teeth to be
completely knocked out. Knocked out baby or primary teeth are usually
not
reimplanted in the mouth, since they will be naturally replaced
by
permanent teeth later. However, knocked out permanent teeth
should be
retrieved, kept moist, and placed back into their sockets
(reimplanted) as
soon as possible. The most important variable affecting the
success of
reimplantation is the amount of time that the tooth is
out of its
socket. Teeth reimplanted within one hour of the accident
frequently
reattach to their teeth sockets.
The knocked out tooth is rinsed in clean water or milk and
placed back
(reimplanted) into the socket from which it came. This can be
done by the
patient or parent and then checked by the dentist. Care should
be taken to
handle the tooth only by its crown and not by its root. If the
parent or
patient is unsure about reimplanting the tooth, then the tooth
should be
stored in milk (if available) or in water and brought to the
dentist as
soon as possible. Alternatively, in older children and adults
who are
calm, the tooth may be held within the cheeks inside of the
mouth while
traveling to the dental office.
After reimplanting the tooth into its original socket, the
dentist can
then splint this tooth to adjacent teeth for two to eight weeks.
Splinting helps to
stabilize it while the bone around it heals. During the
splinting period,
the patient eats soft foods, avoids biting on the splinted
teeth, and
brushes all the other teeth diligently to keep the mouth as
clean as
possible.
In adults, the reimplanted tooth should have a root canal
procedure
within seven to 10 days. On the other hand, reimplanted permanent
teeth in
children (where the tooth root has not yet completely formed)
may not need
a root canal procedure. These teeth are observed for at least
five years
for symptoms of dying pulp, such as pain, discoloration, gum
abscesses, or
abscesses seen on an X-ray.
In most patients who have had tooth reimplantation, over-the-counter
medications like acetaminophen (Tylenol) or ibuprofen (Advil)
are
sufficient for pain relief. Chlorhexidine (Peridex) mouth rinse
may be
prescribed to prevent and control gum inflammation
(gingivitis), since the
splinted teeth cannot be brushed normally and the splint
usually collects
extra dental plaque and food debris. Oral antibiotics and
tetanus toxoid
injections are considered for patients with accompanying
significant soft
tissue cuts (lacerations).
Toothache usually refers to pain around the teeth or jaws. In most instances, toothaches are caused by tooth or jaw problems, such as a dental cavity, a cracked tooth, an exposed tooth root, gum disease, disease of the jaw joint (TMJ), or spasms of the muscles used for chewing. A toothache can also be caused by a problem that does not originate from a tooth or the jaw, like diseases of the heart (angina or heart attack), ear infections, and sinus infections. A thorough oral examination, which includes dental X-rays, can help determine the cause.
Find out more about how orthodontic braces and retainers can provide proper alignment to crooked teeth. Get answers to all your braces questions about care, clear braces, and color bands.
The most common cause of a black eye is due to an injury to the face or head. Most black eye injuries are minor and heal on their own, however, some may lead to significant injury. In addition to trauma to the face, cosmetic surgery can cause a black eye(s) as a side effect. People should be aware of the situations in which medical care should be sought immediately for a black eye.
Endocarditis, a serious infection of one of the four heart valves is caused by growth of bacteria on one of the heart valves; leading to an infected massed called a "vegetation." The infection can be caused by having bacteria in the bloodstream after dental work, colonoscopy, or other similar procedures. Endocarditis symptoms include fever, fatigue, weakness, chills, aching muscles and joints, night sweats, edema in the legs, feet, or abdomen, malaise, shortness of breath and small skin lesions. Treatment for endocarditis is generally aggressive antibiotic treatment.
Learn more about what cavities like, their symptoms, treatment and prevention. See how tooth decay, plaque and bacteria contribute to the creation of cavities and how regular brushing and flossing can help.
Children's health is focused on the well-being of children from conception through adolescence. There are many aspects of children's health, including growth and development, illnesses, injuries, behavior, mental illness, family health and community health.
First aid is a complicated subject and it is situation-specific. First aid is the help and medical assistance that someone gives, not only to an injured person, but to a person who is sick. Preparedness is a key element of first aid, like having basic medical emergency kits in your home, car, boat, or RV. Cuts, puncture wounds, sprains, strains, nosebleeds are one type of injury that may require first aid; heart attacks, strokes, seizures, and heat stroke are examples of more critical first aid emergencies.
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