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Toothache: A dentist or the emergency room?

July 23rd, 2025

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 .

Is a Lost Tooth a Lost Cause?

July 16th, 2025

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.

Top Things to do BEFORE You Get Braces

July 9th, 2025

So you’re about to get braces. Congratulations! You are taking a very smart step to improve the health of your teeth as well as get that killer smile in shape. But, as with anything that is good for you, there are a few things you will have to avoid while you “do your time.”

Some foods don’t do so great with braces. The foods listed below should be avoided while you are wearing your braces because they can pop the brackets and bend the wires. In other words, these foods can really ruin your day, and send you back to Garai Orthodontic Specialist to get your braces repaired.

So before you hit the chair, hit the grocery and candy store – one last time – for:

  • Beef jerky
  • Raw carrots
  • Taffy
  • Pizza crust
  • Bagels and other crusty bread
  • Popcorn
  • Hard candy
  • Nuts and seeds

Dr. Allen Garai & Dr. Karen Tratensek and our staff will give you more information about eating with braces. Some foods, such as apples, are okay as long as you cut them in pieces first. Others, like pudding and pasta, are fine just as they are. But then there is “the list”: the foods that are a big no-no and should be avoided. It won’t be forever, so hang in there.

Your braces time will pass before you know it and you can resume more normal eating. But before the braces go on, enjoy these tasty treats. Go ahead and indulge!

Celebrate the Fourth with a Smile!

July 2nd, 2025

As our nation prepares to observe its birthday, we’d like to share some timely dental tips to help make celebrating the Fourth of July more enjoyable for you and healthier for your teeth and gums.

Hydrate

It might be hot and humid where you’re living, so be sure to keep hydrated in the backyard or along the parade route. Proper hydration is essential for both your overall health and your oral health. Drinking water helps prevent cavities by washing away food particles and bacteria and reducing acidic conditions in the mouth. 

Use Ice for Cooling, not Chewing

If you’re enjoying an icy cold beverage to beat the heat, don’t crunch down on that ice! Chewing on ice can lead to immediate disaster in the form of a chipped or cracked tooth or a broken filling or crown. And, over time, munching ice will damage your enamel, making your teeth more sensitive to heat and cold and more vulnerable to cavities. 

Enjoy All Your Cookout Favorites

If you celebrate the Fourth with family and friends, there’s a good chance you’re celebrating outdoors. According to surveys, Independence Day is the most popular grilling day in the country. Are you sitting on the picnic table sidelines because of loose teeth, tooth pain, or missing teeth? Don’t miss out on any of the fun in Vienna, VA & Great Falls VA! 

  • Tooth pain can be caused by cavities. It can also be a sign of a damaged tooth or an infection. If you suffer persistent tooth pain lasting several days or more, it’s time for a dental appointment.
  • Gum disease can cause bone loss, loose teeth, and lost teeth, making sharing a meal with friends something you avoid instead of something you look forward to. Regular flossing, cleanings, and checkups will help keep your gums in the pink. If you have advanced gum disease, we can discuss treatment options.
  • If you or a loved one wear braces, be sure your BBQ choices are not only delicious, but safe for wires and brackets. Offer menu options which are braces-friendly—that is, which are soft and easy to eat rather than hard, crunchy, or sticky. Remove kernels from corn on the cob and have utensils available to cut finger foods like burgers and hot dogs into fork-friendly bits. 
  • Missing teeth not only make dining difficult, but can also lead to gum disease, decay, and misalignment in adjacent teeth. To enable you to enjoy your meals and to protect your dental health, talk to Dr. Allen Garai & Dr. Karen Tratensek about implants, bridges, or dentures to make your smile complete again.

Whether you’re marching in the parade, enjoying a meal with family and friends, oohing and aahing at the fireworks, or all of the above, we wish you a healthy and happy Fourth of July! If you have any dental concerns, we’re here at Garai Orthodontic Specialist to help you achieve your best smile every day of the year.

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