The medical examiner’s office said in its report that Williams’ cause of death was from “bacterial sepsis with cerebral abscesses and necrotizing lobar pneumonia due to multiple dental caries and retained dental roots”.

Sepsis and Dental Infections

Sepsis is the body’s extreme response to an infection.  It is a life-threatening medical emergency.  Sepsis happens when an infection you already have triggers a chain reaction throughout your body.  Without timely treatment, sepsis can rapidly lead to tissue damage, organ failure, and death.

Dental sepsis can occur when a dental infection spreads to the bloodstream.

Some possible causes of dental sepsis are:

• Tooth decay or a broken tooth that infects the pulp (inner part of the tooth) and forms an abscess (pocket of pus) in the bone or tissue below.

• Bacteria entering the body through the gumline or any breaks in the gum, cheeks or palate.

One of the first signs of a tooth infection is a sore or throbbing tooth.  If left untreated, you may notice swelling, difficulty chewing, radiating pain, and a possible fever.  If you suspect you have a dental infection, seek treatment as soon as possible.

The following symptoms could indicate that a tooth infection has spread to another part of the body:

• Painful tongue or mouth

• Swelling of the face, neck, and cheeks

• Itching or burning sensation on the skin

• Nausea or vomiting

• Fever

• Severe headache

• Double vision or loss of vision

• Drooping eyelids

• Difficulty breathing

• Confusion

A person should see their dentist at the first sign of a tooth infection.  Early treatment will help prevent the infection from spreading into other tissues.

A tooth infection that has spread is a medical emergency.  Do not wait to contact your dentist or visit the emergency department of the nearest hospital.

Your dentist or doctor will provide treatments to target the infection and stop it from spreading further.

What is Sepsis? | Sepsis | CDC

https://www.sepsis.org/

Serious Tooth Infections | Colgate®

Swimming

Frequent swimmers may be at risk for developing yellowish-brown or dark brown stains on their teeth.

Those who swim more than six hours a week continually expose their teeth to chemically treated water.  Pool water contains chemical additives, which give the water a higher pH than saliva.  As a result, salivary proteins break down quickly and form organic deposits on teeth.  These hard, brown deposits know as swimmers’ calculus, appear most frequently on the front teeth.

Swimmers’ calculus can normally be removed by a professional dental cleaning.

Scuba Diving

Scuba diving can lead to jaw joint pain, gum tissue problems or “tooth squeeze” – pain in the center of the tooth.

These symptoms add up to what’s called “diver’s mouth syndrome” (also called barodontalgia), a condition caused by the air pressure change involved in scuba diving and by divers biting too hard on their scuba air regulators.  Tooth squeeze is caused by the change in air pressure, particularly if a driver has a big cavity, a temporary filling, gum disease, periodontal abscess or incomplete root canal treatment.

The best way to avoid these problems is to visit your dentist before scuba diving and make sure your dental health is tip-top.  Ask your dentist’s advice about fitting the mouthpiece of an air regulator.  Sometimes you can inadvertently swallow dentures during a dive, so if you wear dentures, consult your dentist before diving to discuss any potential problems.

Contact Sports (Soccer, Softball, Basketball, etc.)

Soccer players are more likely than football players to sustain a dental-related injury – and these statistics don’t include pick-up games with your friends!

Soccer is a sport where mouthguards and face masks are not mandatory, upping your odds for mouth and face injuries.  Softball, basketball and pick-up games of touch football involve similar risks.  In addition to causing injuries during contact, these sports also may be costly if you’ve had extensive dental work or wear braces.

When participating in such sports, a mouthguard is your best ally.  It is estimated that mouthguards prevent more than 200,000 injuries each year.  Using a mouthguard can prevent damage to braces or other orthodontic work, as well as prevent mouth cuts, jaw injuries and tooth damage.

Types of Mouthguards

There are several types of mouthguards.  Ask your dentist for advice about which mouthguard solution is best for you.

• Stock Mouthguard.  The lowest cost option is an item that can be bought “off the shelf” from a drug or sporting goods store.  This type of mouthguard offers the least protection because the fit adjustment is limited.  While better than nothing, a stock mouthguard is not considered acceptable as a facial protective device.

• Mouth-formed Protectors.  These mouthguards come as a shell-liner and “boil-and-bite” product form sporting goods stores.  The shell is lined with acrylic or rubber.  When placed in an athlete’s mouth, the protector’s lining material molds to the teeth and is allowed to set.

• Custom-made Mouth Protectors.  The best choice is a customized mouthguard made by your dentist.  This is the most expensive option (and may not be covered by your dental plan), but a custom mouthguard offers the best protection, fit, and comfort level, because it’s made from a cast to fit your teeth.

Grin Magazine

But its legacy goes beyond everyday phrases and record-setting feats on the field – and it’s not always pretty.  When it comes to baseball’s impact on your teeth, there’s a lot less to celebrate,  Here’s a quick look at three dangerous habits commonly associated with the sport.

Chewing Tobacco

Back in the 1850′s, when the baseball craze first began to sweep the nation, no one knew about the harms of tobacco.  Baseball players initially began chewing tobacco because it kept their mouths moist, and they used tobacco spit to soften their gloves.

The risks, however, greatly outweigh these benefits.  Like cigarettes, chewing tobacco is linked to stained teeth, bad breath, root decay, gum disease and even cancer.  Among the Major League stars of the last century, both Babe Ruth and Bill Tuttle died of oral cancer after years spent chewing tobacco on the field.

Although players in the 21st century are much more aware of the dangers of chewing tobacco, the tradition is unfortunately still alive.  It wasn’t until 2011 that Major League Baseball stopped teams from providing their players with smokeless tobacco, and Major League player Tony Gwynn died of salivary gland cancer in 2014.  But it’s not just professional players who have had to fight the habit – chewing tobacco can be found even on high school baseball teams.

To protect your mouth and save your life say “no” to tobacco and choose sugar-free gum instead.

Sunflower Seeds

While it’s not fatal, snacking on sunflower seeds is still a terrible way to treat your teeth.  The habit, which emerged in the 1950′s and 60′s as an alternative to chewing tobacco, puts undue stress on your teeth.  This can lead to enamel loss and even fractures.

Can’t pass up the salty snack?  Try unshelled seeds instead.

Dental Injuries

If you don’t spit or snack on the field, one of the biggest threats to your dental health is the baseball itself.  The impact of the hard ball hurtling through the air can knock out your teeth and even misalign your jaw.  Other baseball-related injuries include broken teeth and cuts and bleeding of the lips and tongue.

According to a study among high schoolers, 16% of high-school baseball injuries affected the mouth and teeth.  Despite these risks, too many baseball players avoid using a mouthguard.

Mouthguards, which can be purchased at a sports store or custom ordered by your dentist, are the No. 1 way to prevent damage to your teeth and jaw.  Whether it’s a game or just practice, don’t step onto the baseball diamond without your mouthguard.

Grin Magazine

• Pick up the tooth by the crown (the chewing surface) not the root.  Locate the tooth immediately; don’t leave it at the site of the accident.  Handle the tooth carefully when you pick it up, and never touch the root of the tooth, only the crown.

• If dirty, gently rinse the tooth with water.  Use only water to gently rinse off any dirt.  do not use soap or chemicals.  Don’t scrub or dry the tooth, and don’t wrap the tooth in a tissue or cloth.

• Reposition the tooth in the socket immediately, if possible.  Try to put the tooth back into its socket right away.  Gently push it in with your fingers, by handling the crown, or position it above the socket and close your mouth slowly.  Hold the tooth in place with your fingers or by gently biting down on it.  

• Keep the tooth moist at all times.  The tooth must stay moist at all times, either in your mouth or, if it can’t be replaced in the socket, put it in milk, in your mouth next to your cheek, or in an emergency preservation kit.  Don’t use regular tap water; root surface cells can’t tolerate that for extended periods of time.

• See a dentist within 30 minutes of the injury.  Bring the tooth with you to your emergency appointment.  It’s best to see the doctor within 30 minutes; however, it is possible to save a tooth even if it has been outside the mouth for an hour or more.

Any time your tooth is fully intact (not broken into pieces), it’s always a good idea to try to save it.

 The thrill of competition from sports is invigorating.  From the off-season training and early morning practices to individuals coming together to achieve a greater goal.  There’s nothing quite like being a part of a team.  With the competition comes the occasional sprain, twist, bruise, or cut.  And sometimes, you could endure a tongue injury.  While they’re not uncommon, it’s an opponent you never expect to face.

Check out this great tongue injury game plan.

Tongue Facts and Functions

Before talking about tongue injuries, it’s good to know all the Xs and Os on your tongue.  Did you know that your tongue has:

• 8 muscles
• 3,000-10,000 taste buds
• Both good and bad bacteria
• The ability to help you say up to 90 words per minute

It’s true.  Your tongue is one strong muscle – vital for eating and speaking.  The tip of your tongue, or the apex, is kind of like the index finger as it is the point of contact with the rest of your mouth.  In comparison, the frenulum is where  your tongue and floor of your mouth meet, as well as your lips and gums.

How Injuries Occur

There’s the potential for contact with many sports, from football and basketball to soccer and hockey, that can lead to a tongue injury.  Usually, that’s due to unintentional biting of the tongue.  Some bites can cause a sting, while some can be more serious with greater pain and bleeding.  If you’ve experienced a typical mouth cut or wound with bleeding, here’s what to do:

• First thing, focus on the bleeding as your tongue has high blood flow
• Apply pressure to the wound with medical gauze or some other sterile cloth for 15-20 minutes
• Apply a cold compress to the injured area, or suck on a piece of ice or popsicle
• After the bleeding has slowed down or stopped, use a warm salt water to rinse, especially after eating

If treated quickly, there’s a good chance you can return to the field, court or rink.

If the Injury is More Urgent

If the injury is more significant, such as with a laceration, you should immediately seek medical attention.  A large gash or laceration could require:

• Stitches
• Antibiotics for infection
• Prescribed pain relief medication

After addressing the bleeding and actual wound, your overall oral health and how your injury could affect it should be considered.  As stated earlier, there’s a lot of bacteria in your mouth on your tongue.  Plus, eating, swallowing, and speaking could be impacted.  Make sure you and your doctor discuss all of these before you’re discharged.

Injury Prevention

Football has helmets to protect heads.  Soccer has shinguards for protecting legs.  To help protect tongue injuries, mouthguards are the answer.  Nearly all contact sports recommend wearing mouthguards for protecting your jaw, tongue, teeth and mouth.

The American Dental Association has found that mouthguards help reduce sports-related dental injuries.  It’s a simple solution that can be conveniently worn across multiple sports.  Wearing a mouthguard during competition and practice should eliminate nearly all risk of a tongue injury.

Here are a few tasty game day snacking ideas that are more mouth friendly.

Spicy Jalapeño Dip

What’s in it:

• 1 16 oz. tub low-fat sour cream
• 1 packet of Hidden Valley Ranch (or other brand) Fiesta Dip
• 1 jalapeno, seeded and cubed

How it’s done:

1. Combine all ingredients in a blender and blend thoroughly.
2. Serve the dip with raw vegetables such as carrots and celery.

What makes it tooth friendly:
This dip with a kick will make your veggies disappear. Raw veggies require lots of chewing which stimulates and promotes healthy gums. Carrots contain beta-carotene that your body uses to create vitamin A which works to build strong teeth. The sour cream in this dip gives your teeth a boost of Calcium which also helps to keep your teeth strong.

Hummus with Cucumber

What’s in it:

• 1/4 cup lemon juice
• 2 (15 ounce) cans chickpeas, one drained, one with liquid
• 4 tablespoons sesame seeds
• 2 tablespoons olive oil
• 1 garlic clove, peeled
• 1 teaspoon cumin
• 1 teaspoon salt
• 1 teaspoon pepper
• 1 cucumber
• 1/2 tablespoon parsley

How it’s done:

1. Place all ingredients in a blender in the order listed except for the cucumber.
2. Blend for approximately 1 to 1 and a half minutes, pulsing as necessary.
3. Slice up the cucumber into thick pieces for dipping.
4. Place hummus in serving bowl and drizzle additional olive oil on top with some parsley for garnish.

What makes it tooth friendly:
Protein rich chickpeas don’t contain any saturated fat or cholesterol, making hummus a good choice for your overall health. Chickpeas are also rich in folic acid, which keeps your mouth healthy by promoting cell growth throughout your body. As to the cucumbers, not only are they a healthy alternative to chips, but they are rich in vitamins B and C and have even been shown to help freshen breath and naturally whiten teeth!

The Party Standard: The Meat & Cheese Tray

What’s in it:
This party tray is a cheese buffet with Gouda, White Cheddar, Havarti and Chipotle Jack. Shaped like a football field on a kale turf, it includes red grapes, whole wheat crackers and summer sausage.

What makes it tooth friendly:
The cheese on the sidelines plays quarterback in this party tray. Cheese is a tooth powerhouse with tons of tooth strengthening calcium and a protein called casein which is amazingly effective in protecting the surface of your teeth. One note about the crackers, however.  We chose whole wheat crackers for their beneficial fiber, but all crackers can stick to teeth and promote bacteria growth. Again, just be sure to brush after the game!

Baked Cheese Roll

What’s in it:

• Goat Cheese Log
• Grape or Olive Oil
• 1 small carton of Grape Tomatoes (sliced)
• Basil Pesto
• Balsamic Glaze
• French Bread or Crackers

How it’s done:

1. Preheat oven to 350°
2. In a jelly roll pan or small casserole dish, add approximately 1/4 inch of grape or olive oil.
3. Place goat cheese in the pan and cover with pesto, then grape tomatoes.
4. Bake for 20-30 minutes, remove from the oven and drizzle with balsamic glaze.
5. Serve with French bread or your favorite healthy crackers.

What makes it tooth friendly:
If cheese made from cow’s milk is a powerhouse, goat cheese is a touchdown. It contains more protein and calcium than cow’s milk cheese and yet has less fat and calories per serving. The higher calcium of goat cheese means even more protection for your teeth

Healthy 7-Layer Dip

What’s in it:

• 3 Cups black beans
• 6 Oz. Greek yogurt (plain)
• 1 Cup shredded cheese
• 1 small can sliced black olives

Guacamole:

• 2 avocados
• 2 Tbsp. chopped cilantro
• 1 chopped chive
• Juice from 1/2 lime
• 1 clove minced garlic
• 1/2 seeded and diced Jalapeño

Pico De Gallo:

• 2 small diced tomatoes
• 2 Tbsp. chopped cilantro
• Juice from 1/2 lime
• 1/2 seeded and diced Jalapeño
• 1 chopped chive

How it’s done:

1. Mix together all ingredients for the pico de gallo.|
2. In a separate bowl, mix the ingredients for the guacamole layer.
3. The ingredients can be added in the following order (starting at the bottom): beans, yogurt, cheese, olives, guacamole, pico de gallo.

What makes it tooth friendly:
This dish has it all and it’s a great update of what is usually a calorie dense snack.  While tomato and citrus juices can be tough on your teeth because of their high acidity, the cheese and Greek yogurt help to balance that out.  Plus, this dish is high in vitamins E, A and C, which are all essential for a healthy mouth.  Choosing celery or another vegetable over chips would make this an even better choice for your teeth.

Remember, regardless of what you choose to snack on during the Super Bowl, be sure to brush twice a day for two minutes each time!

Mouth Healthy

Research suggests that overall, athletes view smokeless tobacco as a healthier alternative to cigarettes, they may believe it is a way to enhance athletic performance and suggests that it is socially acceptable.  In fact, athletes who played on multiple sports teams tend to use smokeless tobacco more.

“Smokeless tobacco is not safe and is associated with increased risk for pancreatic, esophageal, and oral cancers.”

Another important factor is the use of smokeless tobacco among professional athletes who are often-times considered role models by youth.

Some professional athletes, such as World-Series winning pitcher Curt Shilling, have come out against the use of smokeless tobacco.  He disclosed he was fighting oral cancer and blamed the disease on smokeless tobacco.  In April of this year, he published, A Letter to My Young Self, as a warning to teens.

Dear 16-year-old Curt,

 

Tomorrow at lunch, a kid is going to dare you to take a dip of Copenhagen.  If you say yes, like I did, you’ll be addicted for the rest of your life.  Well, the rest of your life up to the point when you are diagnosed with cancer.

 

I get what you are thinking.  You’re 16 – you’re invincible, just like all your buddies.  If you were to jump ahead 33 years, you couldn’t write a better dream than the one your life is going to be.

 

With one exception.

 

If you say yes tomorrow, you will become addicted to chewing tobacco and you will get mouth cancer.

 

…

 

Then my advice is simple.  Tomorrow, at lunch, just say no.

 

Make the right choice,

 

-Curt

Opportunities exist for development of stronger tobacco control and prevention measures targeting youth athletes including the health risks associated with all forms of tobacco use.

CDC director Tom Frieden, MD, MPH says,” We can do more to protect America’s youth from a lifetime of addiction.  Because we know tobacco-free policies in schools and other public recreational areas work, we must take action now so that our children are safe from these toxins.”

For more information on this study, view the article here.

Dr. Jackson Winders, DDS is a pediatric dentist who also served as a high school and collegiate football official for 28 years.  He believes that despite new technology in helmet design and the use of over-the-counter (OTC) mouthguards, a custom made, and properly fitted mouthguard is essential to player safety.

Recently, 412 high school football players from six different schools were chosen to participate in a study.  Two hundred and twenty athletes were randomly assigned to wear custom-made mouthguards and 192 athletes wore standard OTC mouthguards of their choosing.  All players wore the same style of helmet.  According to the study, 8.3 percent of athletes using the OTC mouthguard suffered MTBI /concussion injuries.  For those with custom-made mouthguards, the rate was only 3.6 percent.

“The benefits of protecting your child far outweigh the costs associated with a dental or medical injury, which is likelier to occur with a store-bought model.”

Previous studies have theorized that mouthguards can reduce concussion risk because they help absorb shock, stabilize the head and neck and limit movement caused by a direct hit to the jaw.

Together we can tackle concussions head on.  If you have a football player in your family (or someone involved in another contact sport) stop by our office to see what your options are available to you.  We would love to help!

For more information see “Role of mouthguards in reducing mild traumatic brain injury/concussion incidence in high school football athletes,”  in the May/June 2014 issue of General Dentistry