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Posts for: September, 2014

By Dr. James M. Maragos, DDS, PC
September 23, 2014
Category: Dental Procedures
ActorEdHelmsTooth-YankingTrickItWasaDentalImplant

The lengths that some comedians will go to for a laugh! Actor Ed Helms, as dentist Stu Price, pulled out his own tooth in the movie The Hangover. Or did he? Turns out Helms really is missing a tooth, which never grew in. When he was in his late teens, he received a dental implant to make his smile look completely natural.

Helms told People magazine he wasn't exactly eager to remove the implant crown that had served him so well for almost 20 years, but there was no better way to do the famous tooth-pulling scene.

“We started to do different tests with prosthetics and blacking it out and nothing worked,” Helms told the magazine. Helms' dentist said it would be okay to take the implant crown out. “My dentist was really into it,” Helms said. The rest is movie history!

Congenitally missing (“con” – together with; “genital” – relating to birth) teeth are inherited and actually quite common. More than 20% of people lack one or more wisdom teeth, for example. These would not usually be replaced if missing (in fact, wisdom teeth are often removed) but it's a more serious issue when the missing tooth is in the front of the mouth — and not just for aesthetic reasons.

When a particular type of tooth is missing, it disrupts the pattern and function of the teeth. If left alone, sometimes the existing teeth will shift to close the gap. It's like removing a brick from an arch — the rest of the bricks would fall together in a different formation (or collapse entirely). And when upper and lower teeth don't come together properly, they can't function well.

The best treatment for this type of situation is the one Ed Helms had: a dental implant. They look and function like real teeth and do not attach to or damage adjacent teeth as other tooth-replacement options might.

It is important that a child with a congenitally missing tooth wait until jaw growth is complete — different for every person but usually in the late teens — before getting an implant. Otherwise, the artificial tooth might eventually appear too short when the person has stopped growing. In the meantime, there are temporary tooth replacements that can be made.

If you would like more information about options for congenitally missing teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “When Permanent Teeth Don't Grow.” Dear Doctor also has more on “Teenagers & Dental Implants.”


By Dr. James M. Maragos, DDS, PC
September 08, 2014
Category: Oral Health
Tags: jaw pain   tmj   tmd  
DeterminingtheRealCauseofJawPainisKeytoEffectiveTreatment

You’ve suddenly noticed a significant amount of pain radiating from your jaw, so severe you can barely bring your teeth together.

First things first: with this level of pain you should see us as soon as possible. There are a number of possible causes, but only a thorough examination will give us the correct diagnosis and answers we need to develop a plan to treat the cause and alleviate the pain.

With that said, here are a few possible causes for that severe jaw pain.

Injured or diseased teeth. Although the pain you feel seems to come from the jaw in general, the true source may be an individual tooth that’s been traumatized or infected. Because of the interconnectivity of nerves throughout the oral structure, the pain could be radiating from the teeth to the jaws. By effectively treating the affected tooth, we may in turn reduce the jaw pain.

Trauma around the joint. If you’ve taken a physical blow to the area around the jaw joint, the resulting swelling in the joint space is keeping the head of the jaw joint (the “condyle”) from seating in the space properly. You may also notice the upper and lower teeth in the back of your jaw won’t touch. As the swelling from the injury subsides (aided by anti-inflammatory drugs that also reduce pain), the joint should eventually return to its normal position.

Jaw fracture. The most common jaw fracture occurs in the area just below the condyle. The pain is usually much more severe than you might experience with indirect trauma. Fractures are normally treated by repositioning the broken bone and immobilizing the area to allow healing.

Joint dislocation. The injury you’ve sustained may have actually moved the condyle out of the joint space. If this is the case careful manipulation may be needed to reseat the condyle back into place, along with anti-inflammatory medication to reduce swelling.

TMJ or TMD. Muscle spasms can cause significant pain with similar symptoms, including limiting jaw movement. Only an examination with x-rays (to determine if it’s a soft tissue or bone-related injury) can narrow down the possibilities to the true cause. The sooner we make that determination and begin treatment the better you’ll feel — and the less likely the injury will result in irreversible damage.

If you would like more information on the causes of jaw pain, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Jaw Pain — What’s the Cause.”




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James M. Maragos, D.D.S.

Dr. Maragos’ commitment to his community parallels his commitment to his profession. In 2007, he was elected to... 

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