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August 22 is National Tooth Fairy Day! If the Tooth Fairy is a treasured part of your child’s life, you’re just in time to celebrate! But what to do when the Tooth Fairy doesn’t arrive on schedule—when baby teeth stay longer than expected or are lost too soon? 

A baby’s 20 baby teeth tend to come in within a fairly predictable time frame. The bottom central incisors in the very front of your baby’s mouth typically make their appearance first, when your baby is around six to ten months old. Over the next few years, the remaining incisors, canines, and first molars arrive. Last on the scene are the second molars, which usually show up between the ages of 23-33 months. 

Just as baby teeth follow a pattern coming in, they tend to follow the same pattern falling out. The front teeth begin to wiggle and loosen around age six or seven, while the last of the baby teeth, the canines and second molars, are often lost between the ages of ten and 12. 

Baby teeth fall out as the adult teeth below them push up as they erupt. The top of the new tooth puts pressure on the root of the baby tooth, gradually dissolving it. As the root grows smaller and can’t anchor the tooth, the tooth begins to wiggle and eventually becomes loose enough to fall out. This leaves the adult tooth perfectly placed to grow into its proper position.

Sometimes, though, teeth linger far past their fall-out date. Sometimes, because of decay or trauma, they are lost much too early. In either case, Dr. Allen Garai & Dr. Karen Tratensek can provide treatment to protect little smiles now and to ensure that there’s space for the permanent teeth to erupt and align correctly.

Teeth Which Overstay Their Welcome

If that baby tooth never gets wiggly, the team at Garai Orthodontic Specialist can help! When baby teeth stubbornly hang on, adult teeth can erupt behind them, creating a double row of teeth commonly known as “shark teeth.” These permanent teeth can become crowded or misaligned as they try to fit in any space available. Or a baby tooth can block an adult tooth from erupting at all. When that baby tooth just isn’t budging, an extraction will create space for the permanent tooth to erupt.

Extracting a baby tooth is generally a straightforward procedure because primary teeth have very small roots. Your child’s dental team at Garai Orthodontic Specialist are experts in helping you prepare your child for the procedure in a gentle, reassuring, and age-appropriate way. 

Often, a local anesthetic is all that’s necessary for a simple extraction, but if you feel sedation would better fit your child’s needs, discuss sedation options with your dentist. After the extraction, you’ll be given clear information on how to deal with pain and swelling, which foods and drinks are best while the extraction site heals, and how to protect the area.

Teeth Which Exit Too Early

In the case of decay or trauma, Dr. Allen Garai & Dr. Karen Tratensek will do everything possible to save the tooth. When decay is so extensive that there’s not enough structure left to hold a filling or crown, or when there’s an infection in or around the tooth, or when an accident or injury has caused serious damage, extraction might be the healthiest option. Depending on your child’s age, further treatment might be needed afterward to protect future smiles. 

Besides their roles in eating and speaking, baby teeth save space for permanent teeth. Whenever a child loses a primary tooth too soon, the family dentist will be on the lookout for potential future orthodontic problems. If remaining baby teeth shift, taking up part of the empty space left behind by the lost tooth, the adult teeth below won’t have the space they need to erupt properly. Permanent teeth might come in at an awkward angle or in the wrong place. 

In this case, Dr. Allen Garai & Dr. Karen Tratensek might recommend a space maintainer. Space maintainers are small, custom-designed appliances which prevent the remaining baby teeth from shifting position while holding space open for the permanent tooth to arrive right on schedule and right where it belongs. 

It’s comforting to have charts which let us know when little teeth will typically come in and when they will typically fall out. But unexpected events might mean teeth overstay their welcome or depart too soon. When the Tooth Fairy can’t keep to her schedule, schedule an appointment at Garai Orthodontic Specialist in Vienna, VA & Great Falls VA as soon as possible to make sure your child is on track for a future of healthy smiles.

Getting your child excited about braces is a lot like: A) convincing a grumpy toddler that it’s time to take a nap? B) convincing a teenager to stop texting during dinner? C) convincing your husband to eat his peas? The answer, obviously, is all of the above.

And that’s why you may need a few thoughtful ways to get your child on board with braces.

1. Throw a pre-braces party. It can’t be just any party, however, but a Willy Wonka celebration of candy, chips, gum, and all the sticky and sweet foods your child won’t be able to indulge in during the time he or she is wearing braces. Promise a post-braces celebration, too, and watch as your child’s eyes widen at the thought of an all-you-can-eat junk food buffet.
2. Encouraging phrases like “braces aren’t eternal, but your straight smile will be” can go a long way.
3. If your daughter is worried about getting picked on because of braces, then name-drop some A-list celebrities who have worn them. The list includes Cameron Diaz, Kelly Clarkson, Dakota Fanning, and Gwen Stefani.
4. Emphasize that braces today aren’t the same as they were in the Stone Age. From clear ceramic braces to different-colored braces, more options are available. Braces can be cool accessories to express a personal style.
5. To get your child to embrace braces, you need to sing the praises of beautiful teeth, even if that means pointing out how crooked your teeth are because you never got braces.

Emergency care dentists are equipped to handle any tooth emergency. Seeing us first takes less time than having to sit in a hospital emergency room, only to be told to see a dentist. When dental emergencies occur, seek emergency care with Garai Orthodontic Specialist as soon as possible. We are prepared and equipped for any type of dental emergency: day or night, seven days a week, we stand ready to advise and treat you with great dental care.

There are several types of dental emergencies, but only one or two should require a hospital emergency room visit. If you suspect you have a broken jaw or nose, emergency medical attention is required. For pain associated with teeth and gums or injury to a tooth, Garai Orthodontic Specialist is the better choice. Dental pain almost always becomes worse without treatment, and can create other serious health issues.

If a tooth has been traumatized or knocked out of your mouth, our team can treat the sensitive nerves and tissues that could be damaged. If you can replace the tooth quickly enough, chances are it can be saved. There are certain precautions to take during a dental emergency that could help preserve a tooth until you can see our professional dentists for emergency dental care.

Call our Vienna, VA & Great Falls VA office at the first onset of pain. If you have lost a tooth, crown, or filling, try to keep the tooth or restoration moist. Teeth are strong, but they will crack and shift after an injury or the loss of a bridge or crown. If the crack extends to the root, or the loss of a tooth or crown leaves sensitive tissue or nerves exposed, the pain can be excruciating. Our emergency care dentists will always treat your pain immediately upon examination, and fix the problem or advise you of a plan to address the cause of the pain.

Make your appointment immediately if you have suffered an accident-causing tooth injury. If the pain is the result of decay or cavities, medication for infection may be necessary. Depending on the extent of the decay, a filling, extraction, or root canal may be recommended. These treatments are not available in a hospital emergency room, but can be completed quickly and comfortably at Garai Orthodontic Specialist .

We’re used to seeing athletes wearing mouthguards at practice or play, because dental trauma is one of the most common (and predictable) sports injuries. But it’s not just athletes who are at risk, and there are some events in our daily lives that we just can’t predict. Car accidents, falls, workplace injuries, even innocent playground structures can take their toll on our smiles.

A major chip or a crack in your tooth is upsetting enough, and should be seen by Dr. Allen Garai & Dr. Karen Tratensek as soon as possible. It’s even more unnerving when a tooth is knocked out completely. The technical term for a tooth which has been knocked out is an avulsed tooth, and it is a true dental emergency.

If you should suffer a partially or completely dislodged tooth, there is a possibility that your tooth can be reimplanted—if the damage isn’t too severe and if you get to our office immediately.

How can a lost tooth be saved? This is possible because of the complex biological engineering that anchors our teeth within the jaw. The root of a tooth is surrounded by the periodontal ligament. This connective tissue attaches the tooth to the alveolar bone of the jaw. When a tooth is knocked out, this ligament splits apart, leaving some tissue on the tooth root and some within the tooth’s socket.

To successfully reimplant a tooth, the connective tissue cells around the root of the tooth need to be vital, so that they can begin to reattach to the connective tissue left in the socket. Over time, this reattachment is complete, and the tooth becomes firmly anchored to the bone again.

It’s important to protect your tooth before you see Dr. Allen Garai & Dr. Karen Tratensek to make sure there will be enough healthy tissue for reattachment. First of all,

• Don’t panic! If you or a friend or family member lose a tooth, call your dentist or your emergency health care provider as soon as possible. You will get specific instructions for your specific situation.

If you are unable to reach a healthcare provider immediately, there are some general rules for taking care of an avulsed tooth:

• Find the lost tooth. Don’t touch the root—use the crown, or top part of the tooth, to pick it up. You are trying to preserve and protect the connective tissue on the root surface.

• If the tooth is dirty, gently rinse it in milk, saliva, or water. Don’t wipe it off, though. You could damage those connective tissue cells mentioned above.

• Place the tooth back in the socket, if possible. Gently hold it in place with your fingers or bite down (again, gently). You can also place the tooth in your mouth next to your cheek.

• If returning the tooth to the socket is not an option, or if you are worried about a child possibly swallowing the tooth, keep the tooth moist. Whole milk or solutions sold just for the purpose of preserving an avulsed tooth are better choices than water, which damage the tissue cells on the root. And never wrap the tooth tightly—this can also damage the connective tissue.

Above all,

• Don’t delay! The faster a tooth is reimplanted in its socket, the greater chance you have of keeping it. Really, every minute counts. Reimplantations are more successful if they take place within 30 minutes. After an hour out of the mouth, your tooth’s chances of successful reintegration are lower—but still worth pursuing!

What will Dr. Allen Garai & Dr. Karen Tratensek do?

• Evaluate the avulsed tooth.

There are variables which can affect whether or not a lost tooth is a good candidate for reimplantation. Trying to replace a baby tooth, for example, could interfere with the formation of the adult tooth. An adult tooth that is broken will probably require a different type of treatment.

• Prevent infection.

You might be given antibiotics and a referral to your medical doctor for a tetanus booster if needed.

• Clean the site.

The socket will be gently irrigated to clean the area and to remove any clots that may have formed which can interfere with the tooth’s placement.

• Recommend or perform a root canal.

Nerves and blood vessels within the tooth’s pulp generally don’t recover after a serious traumatic injury, so a root canal procedure could be necessary to preserve the health of your tooth. This procedure might be done immediately, or might be recommended for a later date.

• Stabilize your tooth.

The tooth must be stabilized after being reimplanted, so Dr. Allen Garai & Dr. Karen Tratensek will use a splint to anchor the tooth to the teeth next to it. The splint can be flexible or rigid, depending on the condition of the alveolar bone. Splinting generally takes from two to eight weeks, and you will be given detailed instructions for taking care of the area while you heal.

Losing a tooth is an alarming experience. But with prompt action, and a trip to our Vienna, VA & Great Falls VA office, it might be possible to make that loss only a temporary one.