DEAR DR. DONOHUE: I haven’t ever seen anything in your sports items that covered what happened to one of my sons. I have two, and they both play soccer. The past season, one of my boys collided with another player, and his tooth was knocked out. No one was sure what to do. Someone told us to wrap the tooth in tissue, so we did. We got to a dentist about 90 minutes later, and he said he couldn’t use the tooth. It had dried out. Dental work has cost us a great deal of money. How should this have been handled? – A.K.

ANSWER: A knocked-out tooth should be put back in its socket. If it’s dirty, rinse the tooth with water, but don’t rub or scrub the tooth. Scrubbing removes tissues that aid the tooth in re-establishing a solid anchoring in the gums.

If the tooth cannot be maneuvered back into its socket, put it in cold salt water or cold milk. Don’t let it dry out. If need be, have the person with the knocked-out tooth tuck it next to his cheek and gum. The tooth must be kept moist.

Prevention of tooth damage is an important issue. About 600,000 dental injuries end up in emergency departments yearly in the United States. Many of these injuries could have been averted with mouth guards. Those responsible for overseeing any sport where there’s a chance of mouth or tooth injury should insist on their use.

Dentalnotes, a publication from the Academy of General Dentistry, makes some excellent points about the care of mouth guards. They have to be kept clean. Users should brush their teeth before inserting the guards over their teeth. The guards should be cleaned after use. They’re porous, and germs flourish in them unless the guards are taken care of. If a guard has a jagged edge, stop using it and get a new one. Jagged edges can rip mouth and gum tissues.

It goes without saying that mouth guards should not be shared.

DEAR DR. DONOHUE: I am a mailwoman. I don’t know how much I walk every day, but it’s quite a bit. I read that taking 10,000 steps a day keeps one healthy. I have no intention of counting the steps I take. I can measure the miles I walk. Can you convert miles walked into steps? – V.D.

ANSWER: The distance covered by a step varies from individual to individual. We don’t all have the same stride length. If you get a pedometer, a gadget that you clip to your belt, it counts the steps for you. Every time the hip rises and falls, the pedometer registers a step.

Ten thousand steps are roughly 5 miles. Most people take 5,000 steps a day in their daily activities. The additional 5,000 steps are the ones that count for heart exercise.

A 5-foot-6-inch woman takes about 2,033 steps in walking one mile in 16 minutes. The number of steps for a man of the same height walking the same distance in the same time is 1,943 steps. Unless you are a most exact person, you can safely say that there are 2,000 steps in one mile.

DEAR DR. DONOHUE: I am a 57-year-old woman. I participate in aerobic exercise classes three times a week along with lifting weights, Pilates and yoga. I alternate these exercises.

I have been doing these workouts for more than two years. Is it possible to improve my leg and arm strength, or will I stay on a plateau without any more improvement? – L.R.

ANSWER: Your program satisfies all the criteria needed to qualify as excellent exercise for your heart’s health. Even if you are on a plateau, it’s a good plateau to be on.

However, since you brought up the issue of strength, you do constantly have to make new demands on your muscles with greater challenges if you expect to make progress in strength and muscle growth. That means you have to lift heavier weights, increase the number of lifts per exercise or do both. The increments don’t have to be huge, but they have to increase to expect gains.

The human body cannot exceed limitations placed on it by nature. So this is not an eternal progression of heavier weights. I can’t tell you what limits nature imposed on you, but you should be able to figure that out yourself.

Dr. Donohue regrets that he is unable to answer individual letters, but he will incorporate them in his column whenever possible. Readers may write him or request an order form of available health newsletters at P.O. Box 536475, Orlando, FL 32853-6475. Readers may also order health newsletters from www.rbmamall.com

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