Your teeth and gums have a highly sensitive network of nerves. But while it can signal even the most subtle discomfort we may not be able to identify the cause with pinpoint accuracy. As a result, tooth pain could indicate more than one kind of problem including a decayed tooth, root sensitivity, infected gum tissues (like an abscess) or a dying pulp signaled by diseased nerve tissue inside the tooth.
On the other hand, not all tooth pain is the same: it can be dull or sharp, continuous or intermittent. It can feel like a constant, throbbing ache or a sharp wince when you eat or drink something cold or hot, or when you bite down. These differences could point our diagnostic examination in the right direction.
For example, sharp, throbbing pain could indicate deep tooth decay, especially if it suddenly stops. That would likely mean the nerves within the tooth pulp under attack by the infection have died and can no longer transmit pain. The infection, on the other hand is still very much active — this usually requires a root canal treatment (cleaning out the pulp and root canals of diseased and dead tissue and filling the empty spaces) if we’re to save the tooth.
If, however, you’re experiencing sensitivity from temperature or pressure, we could be facing at least a couple of scenarios. For one, your tooth could be fractured. More likely, though, periodontal (gum) disease triggered by bacterial plaque has caused the gum tissues to shrink back (recede) from the affected teeth so that the sensitive dentin layer is exposed and no longer protected by the gum tissue.
If we diagnose gum disease, we’ll need to aggressively remove bacterial plaque from all tooth and gum surfaces. This procedure might require more than one appointment and the possibility of surgery if we encounter deep pockets of infection, especially around the roots. If gum recession is severe you may also need grafting surgery to replace the missing gum tissue or to re-cover the exposed areas of your teeth.
So, knowing the source of tooth pain will direct the course of treatment to follow. With proper treatment, though, the chances are good we can not only restore your teeth and gums to optimum health but we can end the pain.
If you would like more information on treating tooth 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 “Confusing Tooth Pain.”
While cigarette smoking has been linked with lung cancer and heart disease, it, can also contribute to dental disease. You can reduce these risks by doing one thing — quitting smoking.
But that’s easier said than done: forty-six percent of smokers try to quit every year, but only one in ten are successful long term. The difficulty is tied to tobacco’s active ingredient, nicotine, an addictive substance that triggers chemical and behavioral dependence. Nicotine “re-wires” the brain to feel pleasure when it encounters the chemical, and to feel bad when it’s deprived. Social, occupational or recreational activities can further reinforce the habit.
Many smokers try to quit through sheer willpower or “cold turkey.” Because of nicotine’s addictive properties, this rarely works — instead, you need a comprehensive strategy tailored to you.
You should begin first with trying to understand your individual smoking patterns: when do you smoke, how frequently, or during what activities? To help with this you can use a “wrap sheet”, a piece of paper you keep wrapped around your cigarette pack. Each time you take out a cigarette, you would record how you feel on the sheet. This also slows down the action of taking out a cigarette and lighting it, which can help you become less mechanical and more mindful of your habit.
You can also break your dependence by gradually introducing restrictions to your smoking: smoke only in certain locations or at certain times; substitute other stress-relieving activities like a walk or other physical exercise; or gradually reduce the number of cigarettes you smoke. You can do the latter by setting a goal, say to smoke 20% fewer cigarettes each successive week; this will force you to increasingly make choices about when you smoke.
Finally, don’t try to go it alone. You can benefit greatly from professionals, including your dentist, to help you kick the habit through Nicotine Replacement Therapy (NTR) with prescription medication, counseling or smoking cessation support groups.
Quitting smoking isn’t so much stopping a behavior as it is “unlearning” one and establishing new, healthier ones. The first step, though, is accepting you need a change, one that will benefit your whole life.
If you would like more information on quitting smoking, 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 “Strategies to Stop Smoking.”
Other than the common cold, tooth decay is the most prevalent disease in the world. And while a cavity or two may seem like a minor matter, tooth decay’s full destructive potential is anything but trivial. Without proper prevention and treatment, tooth decay can cause pain, tooth loss and, in rare cases, even death.
This common disease begins with bacteria in the mouth. Though these microscopic organisms’ presence is completely normal and at times beneficial, certain strains cause problems: they consume left over carbohydrates in the mouth like sugar and produce acid as a byproduct. The higher the levels of bacteria the higher the amount of acid, which disrupts the mouth’s normal neutral pH.
This is a problem because acid is the primary enemy of enamel, the teeth’s hard protective outer shell. Acid causes enamel to lose its mineral content (de-mineralization), eventually producing cavities. Saliva neutralizes acid that arises normally after we eat, but if the levels are too high for too long this process can be overwhelmed. The longer the enamel is exposed to acid, the more it softens and dissolves.
While tooth decay is a global epidemic, dental advances of the last century have made it highly preventable. The foundation for prevention is fluoride in toothpaste and effective oral hygiene — daily brushing and flossing to removing plaque, a thin film of food remnant on teeth that’s a feeding ground for bacteria, along with regular dental visits for more thorough cleaning and examination. This regular regimen should begin in infancy when teeth first appear in the mouth. For children especially, further prevention measures in the form of sealants or topical fluoride applications performed in the dentist office can provide added protection for those at higher risk.
You can also help your preventive measures by limiting sugar or other carbohydrates in your family’s diet, and eating more fresh vegetables, fruit and dairy products, especially as snacks. Doing so reduces food sources for bacteria, which will lower their multiplication and subsequently the amount of acid produced.
In this day and age, tooth decay isn’t a given. Keeping it at bay, though, requires a personal commitment to effective hygiene, lifestyle choices and regular dental care. Doing these things will help ensure you and your family’s teeth remain free from this all too common disease.
If you would like more information on preventing and treating tooth decay, 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 “Tooth Decay.”
Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.
In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.
Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.
What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.
Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.
A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”
As we age we become more susceptible to dental diseases. A common but often initially unnoticed problem for seniors is root decay.
We’re all familiar with tooth decay in the crown, the visible tooth above the gum line. Bacteria feeding on leftover sugar in the mouth produce acid, which at high levels erodes the teeth’s protective enamel. This forms cavities and, if untreated, deeper infection within the tooth that could reach the bone via the root canals.
But decay can also directly attack a tooth’s roots below the gum line. Roots are made of dentin and covered by a very thin layer of mineralized tooth structure called cementum. Cementum, which is much softer than enamel, is often lost because of its thinness, thus exposing the root’s dentin. This can make the area more susceptible to decay than the enamel-covered crown. Normally, though, the roots also have the gums covering them as added protection against bacterial infection.
But gum recession (shrinkage), a common experience for people in their later years, can expose the root surfaces. As a result, the roots become much more susceptible to decay. And an ensuing infection could spread more quickly into the interior of the tooth than decay originating in the crown.
That’s why it’s important to remove the decayed material and fill the root cavity to prevent the infection’s spread. While similar to a crown filling, the treatment can be more difficult if the root cavity extends below the gum line. In this case, we may need to perform a surgical procedure to access the cavity.
There are other things we can do to help prevent root cavities or limit their damage. We can apply fluoride varnish to strengthen the teeth and provide extra protection against cavities, or prescribe a fluoride rinse for use at home. We can also keep an eye out and treat periodontal (gum) disease, the main cause for gum recession.
The most important thing, though, is what you do: brush and floss thoroughly each day to remove bacterial plaque and limit sugary or acidic foods in your diet. Preventing decay and treating cavities as soon as possible will help ensure you’ll keep your teeth healthy and functional all through your senior years.
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