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When you chip a tooth badly, it can be a very nerve-wracking situation. Dr. David Shipper and Dr. Howard Vogel and our team want to provide you with some information that can help if you ever suffer a chipped or broken tooth. The most common ways people break their teeth are by biting down on something hard, getting hit in the mouth, falling down, or developing cavities that weaken the tooth and allow it to be broken easily. There are a few things you can do if you find yourself in this situation, however.

First, we recommend that you investigate whether the tooth is partially chipped or completely broken. Unless you are experiencing a lot of pain or bleeding, this should not be treated as an emergency. You may call our office and we will try to schedule an appointment with you as soon as possible. Once we have evaluated the tooth during your appointment, we can start to treat it. For minor chips or cracks, we may simply smooth out the area or fill in the space so the crack doesn’t spread.

If your teeth show severe damage such as a serious break, split tooth, split root, or a decay-induced break, Dr. David Shipper and Dr. Howard Vogel may need to take more time to fix the problem. If you need emergency dental care because a tooth has fallen out, call our practice immediately to schedule an appointment for that day. If you’re waiting for an emergency appointment, you can rinse your mouth with warm salt water and apply slight pressure to the area to stop the bleeding. We recommend using an ice pack to reduce swelling, but do not take any aspirin because that may increase the bleeding.

If your tooth has completely fallen out of the socket, hold it by the crown and rinse it under running water. Do not let the tooth become dry; instead, place it in salt water or milk until you get to our office. Dr. David Shipper and Dr. Howard Vogel will determine whether the broken tooth can be salvaged or will need to be completely replaced.

We know how upsetting it can be to chip or break a tooth, which is why we want to guide you through this process. Most chipped teeth are usually just cosmetic problems, fortunately, but we know that dental emergencies can come up rather suddenly. Be sure to schedule an appointment at our New York, NY office as soon as an emergency situation occurs.

Imagine that you’re only going to brush your teeth once tomorrow. Don’t worry, we know you would never skimp on your dental hygiene like that, but let’s just pretend for a moment. When would be the best time to brush? When you wake up? During the day? Or perhaps before you go to bed?

Actually, whenever you choose to brush, you’ll receive important overall dental benefits as well as specific benefits tied to the time of day. Let’s explore your daily schedule to see why.

Brushing in the Morning

Brushing when you first jump out of bed produces several positive results.

• Cleaning plaque from your teeth

Plaque is a sticky film made up of oral bacteria, food particles, and saliva. As you sleep, these oral bacteria multiply and produce acids which attack the minerals in your enamel, leaving weak spots which, over time, can become cavities. Brushing removes these bacteria and acids from your enamel before they cause serious harm.

Moreover, plaque hardens if it’s left undisturbed, turning into tartar in a relatively short time. And once plaque becomes tartar, it must be removed by a dental professional. Brushing first thing in the morning removes this plaque buildup and helps prevent tartar from forming.

• Fresh breath

That bacterial growth we mentioned? It’s also responsible for morning breath. If nothing else, brushing when you wake up means greeting a fresh day with fresh breath, and that’s reason enough to pick up your brush in the morning.

Brushing During the Day

Brushing after meals and snacks also has a lot to recommend it.

• “Leftovers” lead to cavities

Foods, especially foods rich in sugar and carbohydrates, are converted by oral bacteria into acids which weaken enamel and lead to cavities. When food particles remain in the mouth after a meal, bacteria have more time and more fuel to manufacture these acids.

• Acidic foods also affect your teeth

If you have eaten something acidic, such as citrus fruits, sodas, or pickled anything, the acids from these foods can temporarily weaken the mineral strength of your enamel. But brushing immediately after eating or drinking acidic foods can damage weakened enamel. Better to rinse well with water and brush after half an hour or so.

Brushing at Night

Growing up, you probably received regular reminders to brush before bedtime—for several really good reasons:

• Saliva production slows while you sleep

During the day, saliva helps to wash away food particles and neutralize acidity in our mouths. It also contains proteins and minerals which help keep tooth enamel strong. But as we sleep, saliva production slows dramatically, and our bodies can’t remove bacteria and acids as effectively.

• Food particles fuel bacterial growth

If you haven’t brushed since morning, you’ve accumulated a whole day’s worth of food particles from meals and snacks. Remember, oral bacteria use the sugars and carbs we eat as fuel to produce the acids which attack our tooth enamel throughout the night.

• Brushing helps prevent both of these problems

Brushing your teeth before bed not only cleans away the accumulated food particles of the day, but also eliminates the plaque and bacteria which would have a much easier time sticking to your teeth without that daytime saliva flow to wash them away.

So, When’s the Best Time to Brush?

In the morning, during the day, at night —there are solid advantages to brushing any time of day. The question isn’t so much when to brush as how often you should brush.

While many dental professionals consider brushing before bedtime as the most important brush of the day, brushing at least two full minutes, at least twice during a 24 hour period, is a necessity for basic dental hygiene. (And don’t forget to floss at least once each day.)

If you wear orthodontic appliances, if you’ve been eating sugary snacks, if you’re showing signs of gingivitis or getting more than your share of cavities, if you want to reduce the chance of plaque and tartar buildup, or if you simply want to make sure you’re doing everything you can to maintain your overall dental health, brushing after meals is also highly recommended.

Talk to Dr. David Shipper and Dr. Howard Vogel about your brushing habits the next time you visit our New York, NY office. No need to use your imagination to plan your best brushing schedule. We have all the answers you need to help you brush your way to your best—and healthiest—smile!

In years past, it was often recommended that dental patients who had a history of heart problems or other conditions, such as joint implants, be given antibiotics before any dental work. This pre-treatment is called prophylaxis, based on the Greek words for “protecting beforehand.” Why would Dr. David Shipper and Dr. Howard Vogel suggest this protection? It has to do with possible effects of oral bacteria on the rest of the body.

Our bodies are home to bacteria which are common in our mouths, but which can be dangerous elsewhere. If these oral bacteria get into the bloodstream, they can collect around the heart valve, the heart lining, or blood vessels. A rare, but often extremely serious, infection called infective endocarditis can result.

It is no longer recommended that every patient with a heart condition take antibiotics before dental procedures. Doctors worry about adverse effects from antibiotics or, more generally, that an overuse of antibiotics in the general population will lead to more strains of antibiotic-resistant bacteria.

There are some patients, however, who are at a higher risk of developing infective endocarditis, and who should always use preventative antibiotics. Generally, premedication is advised if you have one of these risk factors:

• A history of infective endocarditis
• Certain congenital heart conditions (heart conditions present since birth)
• An artificial heart valve
• A heart transplant

Your cardiologist will know if prophylaxis is advisable, and if you are taking any drugs which could interact with antibiotics. Always talk to your doctor about any dental procedures you are planning, particularly if they are invasive procedures such as gum surgery or extractions.

If you believe you would benefit from antibiotics before dental treatment at our New York, NY office, the most important first step is to talk with your doctors. We are trained to know which pre-existing health conditions call for prophylaxis, which dental procedures require them, which antibiotics to use, and when to take them. Tell us about any health conditions you have, especially cardiac or vascular issues, and any medication allergies. Working with you and your doctor to protect your health is our first priority, and having a complete picture of your medical health will let us know if antibiotic prophylaxis is right for you.

Quick trivia question: define “mamelon.” Some kind of warm blooded animal? No, not a member of the mammal clan, but good guess. A fruit of the gourd family? Nope! There are watermelons, and honeydew melons, and even canary melons, but no ma-melons. Those little rounded bumps you notice on the edge of your child’s permanent incisors when they first emerge? We have a winning answer!

• Why Do We Have Mamelons?

We have eight incisors, or biting teeth, in the front of our mouths—four on top and four on bottom. Mamelons are actually a clue as to how these incisors were formed. Even before a baby is born, the permanent teeth begin to take shape. Three different groups of cells develop to form the incisal edge of these front teeth. As they fuse together, they create three lobes of enamel on the erupting edge of the tooth. It’s these lobes, or bumps, that give the teeth a serrated appearance.

Whether your child’s mamelons are quite prominent or barely noticeable, if you are worried about them, relax! They are almost always a temporary part of your child’s smile, and disappear over time with chewing and normal wear. But what if the mamelons overstay their welcome?

• Cosmetic Concerns

Because mamelons are composed of enamel, without the underlying dentin layer found in the body of the tooth, they can appear translucent or a bit different in color. They might wear away unevenly, leaving the tooth edges looking misaligned. Or, they might not wear away at all if your child’s tooth eruption is delayed. Talk to Dr. David Shipper and Dr. Howard Vogel if mamelons are a cosmetic concern for you or your child. You might discover that they are wearing away naturally, or we can discuss ways to polish or smooth them down if needed. This is a painless procedure that doesn’t require an anesthetic. Generally, however, this is a matter where time will resolve the issue for you.

• Orthodontic Implications

Occasionally, mamelons might become a topic of discussion for orthodontic reasons. Sometimes, mamelons do not wear away over time because of a malocclusion (misaligned bite). Your orthodontist will let you know your child has a bite problem and can explain treatment options. Your orthodontist might also suggest smoothing away the mamelons to ensure that the edges of the incisors align correctly and symmetrically while the teeth are in the process of straightening. Again, this is not always considered a necessity, so weigh your options with your dental care provider.

So, if you notice that your child’s beautiful new teeth are bumpy or serrated as they erupt, don’t be concerned! If you have any questions about mamelons, talk to Dr. David Shipper and Dr. Howard Vogel at your next visit to our New York, NY office. This is a natural occurrence and most likely just a temporary “bump” in the road. Soon enough, mamelons will be a memory—and the answer to a pretty difficult trivia question.