Dental Trauma

Dental trauma is most common in pre-school children that are learning to walk, run, jump and climb, and in school-age children playing sports, but can happen anytime. Our team wants to help your family feel prepared to handle these emergencies.

The most common types of trauma in baby teeth are movements of the teeth in the bone displacing them in one direction or another. At that time, damage to the supporting ligament or fracture of the bone is also possible. Examination and treatment at this age can be difficult due to fear and lack of cooperation. Treatment of these luxation injuries must consider having the least amount of risk to damage permanent teeth developing underneath. Most heal spontaneously and no treatment at the time of injury may be necessary. In more severe luxation injuries, an extraction may be the treatment of choice. If a baby tooth is knocked out of the mouth, it is best NOT to re-implant the tooth due to poor healing capability and possible injury to the developing permanent tooth underneath it.

The most common type of trauma in the permanent dentition is a crown fracture. This can vary from slightly chipped teeth to fractures of majority of the crown even exposing the nerve of the tooth. We recommend keeping the tooth fragment that broke of as we may be able to bond it back to the tooth. Otherwise, a composite restoration can be done. X-rays of the lip or cheek may also be taken to search for lost tooth fragments. If the nerve is exposed, a pulpotomy may need to be done. Pulpotomy is a procedure where the infected pulp tissue is cleaned, medicine is placed and then the fracture is

restored. Lastly, some fractures could be so severe that the tooth may need to be splinted to the adjacent teeth for stability. A wire will be bonded to the injured tooth and adjacent teeth for a few weeks while the bone and supporting ligaments heal.

If a permanent tooth is knocked out, it’s important to put the tooth back into its socket as quickly as possible. Time is of the essence in these emergencies. The long-term survival of the tooth after 15 minutes outside of the mouth declines quickly. Second best option is to store it in the child’s saliva or in cold milk. Do NOT store the tooth in water. Call our office immediately so we can splint the teeth together to stabilize the tooth in the socket. In some cases, especially if the tooth is not in a safe storage solution for more than 60 minutes, the long-term survival is poor and a root canal may have to be done.

After trauma to the teeth, we recommend monitoring the teeth over time for signs and symptoms of infection even if the child does not feel pain. Most common signs are: 1) discoloration of the teeth 2) mobility of the tooth 3) swelling and infection that look like a bubble overlying the gum of the injured tooth.

For the best chance of long-term survival, call our office as soon as possible when trauma occurs. We are always on call for our patients. You can also ask us about our dental trauma protocol at your next routine check-up.

Dr. Lindhorst, Dr. Darsey, Dr. Theriot, Dr. Rodgers and the Heights Pediatric Dentistry and Orthodontics Team

CLEFT LIP AND PALATE – Dental and Orthodontic Considerations

We are super excited to have Dr. Anika Rodgers on our team! Along with working at Heights Pediatric Dentistry and Orthodontics, Dr. Rodgers also works at Texas Children’s Hospital as a Craniofacial Orthodontist in the Plastic Surgery department. As a member of the cleft and craniofacial team, Dr. Rodgers helps to treat patients born with a variety of facial abnormalities including cleft lip and palate, hemifacial microsomia, Crouzon Syndrome, Apert syndrome and Pierre Robin Sequence. As a craniofacial orthodontist she is also trained in NasoAlveolar Molding (NAM) and begins to work with patients born with cleft lip and palate as early as one week of age. In conjunction with the other specialists on the cleft and craniofacial team, she is able to manage the orthodontic needs of patients born with craniofacial abnormalities from the time of birth up through adulthood. 

In orthodontics we treat many patients with an array of different misalignments of the teeth. We often treat kids with complex medical and dental needs as well. Cleft lip and palate can be one of those complex treatments. A cleft occurs when certain structures do not fuse together during fetal development. Clefts can involve the lip, the palate, or both lip and the palate. A cleft lip presents as an opening of the lip on one side or both sides of the face and depending on how severe the cleft is, it may extend up into the nose. A cleft palate is an opening in the roof of the mouth, known as the palate. The average incidence of cleft lip and palate is 1:750 births. 

Of the different variations of cleft lip and cleft palate, each individual cleft is treated in its own unique way both surgically and orthodontically. One of the main dental issues with having a cleft is the possibility of missing teeth in the area of the cleft. The common tooth to be missing in the region of the cleft is the lateral incisor. This orthodontic challenge can be overcome with the use of braces either closing the space or making room to replace that missing tooth with a future bridge or implant. 

Another issue in patients with cleft lip/palate is that teeth could erupt (come into the mouth) in inappropriate locations. Teeth can be misaligned, rotated and even blocked out and unable to erupt. This can cause problems with brushing, and maintaining excellent oral hygiene becomes a challenge. Team approach between an orthodontist and a pediatric dentist is extremely important in upholding excellent oral health in these patients. Our HPD&O team is excited to have both orthodontists and pediatric dentists here to provide the best and most efficient treatment for our patients. If you have any questions regarding treating dentally complex patients please don’t hesitate to contact us. 

Dr. Rodgers, Dr. Darsey, Dr. Lindhorst, Dr. Theriot and our Heights Pediatric Dentistry and Orthodontics Team 

Sugar in a Bottle

Marketing companies are amazing at well… marketing. It’s no wonder that most families’ refrigerators are stocked with “healthy” juice, sodas, and Gatorades. As dentists we cringe at the site of eye level positioned and well-advertised liquid sugars on grocery store shelves. Labels show clearly that the amount of sugar packed in juice much exceeds daily recommended levels. A normal size adult should have no more than 25 g of sugar per day, which amounts to around 6 tsp. A glass of typical juice has between 35 and 60 grams of sugar. Sports drinks do not trail far behind with around 40 grams of sugar. Because of lack of true regulations on food labels, even juices that claim to be “100% natural fruit” often have sugar added, other juices mixed in for volume and flavor, or are stored in tanks for a long time, which makes it necessary to add preservatives containing sugar. All these drinks are also extremely acidic due to naturally occurring fruit acids as well as added preservatives such as citric acid. This makes their acidity close to battery acid. 

As health professionals and dentists, our worry is both on a large scale of body health, and on a small scale of teeth. We witness staggering BMI numbers that lead to problems such as diabetes, heart problems, social difficulties, and behavioral issues starting in childhood and culminating in solemn complications in adulthood. We see more and more kids with diabetes, kids who have difficulty exercising and keeping up with their peers, and kids with serious social tensions due to weight. Our role as health providers often puts us in a position where we must counsel and educate parents and families to reinforce information already discussed by their family physicians. 

However, as dentists we are concerned about teeth in particular. Acid in juices can cause erosion of enamel, the hardest structure in your body. Acid creates wear and damage that allows for sugar to easily fit in the microscopic holes on teeth. Worn enamel will demineralize making work of cavity- causing bacteria easy, especially with addition of large amount of sugar, which fuels them. We see rampant cavities in children as young as two years of age. Dental decay is number one reason for missing school hours in young children and is still the most prevalent chronic disease in both children and adults. Costs of dental decay are staggering as many young children end up with expensive treatment including hospitalizations for infections or treatment with IV sedation. Prevention of dental decay is not contained to limiting sweet drinks, but in the face of today’s epidemic, we want to educate our families early and thoroughly on all controllable variables. Eliminating sugary drinks is an easy step in overall personal health and in dental well-being of our patients. Please feel free to contact us with any particular questions. 

Dr. Lindhorst, Dr. Darsey, Dr. Theriot and Heights Pediatric Dentistry and Orthodontics Team 


Jumping on a trampoline, skate boarding, gymnastics, playing hockey, baseball, or basketball are just some of the fun activities kids engage in every day. Although very different, all of these activities have one thing in common: the potential for trauma to the mouth, face, and jaw. Trauma may include fractured or avulsed teeth, broken jaws, laceration of the soft tissues, concussions, and many others. Any of these injuries could impact the way you smile, talk, and eat forever. This can all be easily prevented by wearing a properly fitted mouthguard.

Studies have shown that athletes are 60 times more likely to suffer harm to the teeth if they are not wearing a mouthguard. Mouthguards are recommended to be worn at all times during recreational activities and sports, including practices. We all know that convincing a child to do so will require a comfortable device that does not obstruct his or her ability to talk and excel in the sport of choice.

There are three types of mouthguards: ready-made or stock mouthguard, “boil and bite” mouthguard, and a custom-made mouthguard fabricated by your dentist. According to the American Dental Association, the mouthguard should fit properly, be durable, be easy to clean and not restrict speech or breathing. The best mouthguard is one that is custom-made to fit your mouth. These kinds of mouthguards are tailored to the individual’s mouth, they are gentle on the soft tissues like cheeks and gums, and can be adjusted by your dentist to ensure proper fit over time.

“What if I have braces? Can I wear a mouthguard?” Absolutely! A mouthguard will provide a cushion between your braces and your lips and cheeks. This will prevent damage to the braces but also protect the soft tissues of the mouth. Typically, mouthguards are made to fit on the upper teeth, but if you have appliances that prevent wearing a mouth guard on the top teeth, a custom-made mouthguard for the bottom teeth is possible. Talk to us about which mouthguard is best for you.

Protect your mouth and your smile. Wear a mouthguard!


All conversations about orthodontics these days include Invisalign. Of all the options we have to straighten teeth, it is the most esthetic and accepted treatment we offer. The most common questions we get about the aligners are if they work, if they hurt, and what is the cost?

Invisalign does work! Invisalign is essentially a series of removable clear aligners (much like the bleaching trays) that are worn day and night to align the teeth.  They are almost invisible and allow our patients to speak clearly and smile without visible braces. Since the aligners are removable, compliance is absolutely necessary to get a great result so it takes a persistent patient for the success of Invisalign.  Since compliance is critical, the majority of our Invisalign patients are adults.  However, some teen patients have been excellent at wearing them as well. In addition, with new research and developments, we have been pushing the envelope of treating more difficult orthodontic cases with Invisalign where braces were traditionally the only option.

So how does it work? Each aligner slightly moves the teeth and treatment consists of a series of aligners, each a little closer to the ideal bite, to progressively straighten teeth.  The more complicated the bite correction is to begin with, the more aligners and greater the length of treatment will be needed. Since the movement with each aligner is slight, the pressure and discomfort are minimal. Most of our patients adjust to wearing their new aligners very quickly as there are no brackets or wires to get used to.

 The cost of Invisalign treatment depends on the length of treatment and number of aligners necessary.  It is however, close to the same price as adult braces.  It can be as few as five aligners for minor treatment.  Longer treatments last between six and twelve months, which is generally shorter than patients expect.  The treatment and cost will be customized to fit patient’s concerns. We work with our patients to make each treatment the most economical for the desired effect.

We have seen that many patients, especially adults who do not desire to have metal braces, have put off orthodontic treatment because of questions about Invisalign.  Now that they have been answered, all the specifics of an individual’s needs can be answered during our complimentary consultation.  Dr. Darsey is a Board Certified orthodontist and has in-depth knowledge as well as ample experience with Invisalign.

The road to straight teeth is easier and shorter than most patients expect.  The key is starting as soon as possible to enjoy a beautiful new smile for a lifetime!

Dr. Lindhorst, Dr. Darsey, Dr. Theriot and Heights Pediatric Dentistry and Orthodontics Team