Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Trauma to the face or teeth can be caused by auto accidents,
falls, and
injury from sports such as football, hockey, soccer, volleyball,
basketball, and baseball, etc. Patients suffering significant
head, neck,
or facial trauma should be evaluated and treated in hospital
emergency
rooms. Such trauma may involve bleeding from the nose or ears,
concussion,
dizziness,
lapse of memory, disorientation, severe headache and
earache,
or breaking (fracture) of the skull and/or jaws. Most hospitals have on their staff oral surgeons who can treat fractures of the upper
or lower
jaw and perform emergency tooth removal (dental extractions) and
reconstruction of the dental arches.
Wear and tear due to cavities and chewing hard objects, such as
pencils, ice
cubes, nuts, and hard candies, can also lead to tooth
fractures. Dental
injury without associated head and neck trauma can be evaluated
and
treated in a dental office. Such dental injuries include broken
(fractured) teeth, teeth totally knocked out of the mouth, or
teeth
displaced by unexpected external forces. These dental accidents
may be
associated with swelling of the gum and oral tissue. Cold packs
or ice
cubes placed either inside the mouth directly above the injured
tooth, or
outside on the cheeks or lips, can reduce pain and swelling
before the
patient reaches the dentist.
What is a tooth fracture?
Tooth fractures can range from minor (involving chipping of
the outer
tooth layers called enamel and dentin) to severe (involving
vertical,
diagonal, or horizontal fractures of the root). Enamel and
dentin are the
two outer protective layers of the tooth. The enamel is the
outermost
white hard surface. The dentin is a yellow layer lying just
beneath the
enamel. Enamel and dentin both serve to protect the inner
living tooth
tissue called the pulp. The visible one-third of the tooth is called
the crown,
while the remaining two-thirds of the tooth buried in the bone is
called the
root. Dental X-rays are necessary in most instances to
diagnose, locate,
and measure the extent of tooth fracture.