Posts for: October, 2018
You may be among the one in three Americans who suffer from the pain of tooth sensitivity. Before attempting treatment, though, we must first identify the cause.
Your teeth are made of layers of different organic tissue. The pulp at the center of the tooth contains nerves that transmit pain or pressure sensation to the brain. The pulp is encased by dentin, a layer of tissue composed of tiny tubules that conduct temperature and pressure changes from outside the tooth to the pulp nerves. The hard outer enamel shell shields the dentin from over-stimulation from these sensations.
There are, however, some instances where the dentin may become exposed and cause sensitivity in the tooth. This can occur when the gum tissue recedes and the root of the tooth is exposed to the oral environment. If the root loses its surface coating (referred to as cementum, a cement-like outer layer around the root surfaces) because of over-aggressive brushing (too hard for too long) or advanced periodontal (gum) disease, sensitivity is often the result.
Another instance is enamel erosion. Although made of the hardest substance in the human body, enamel has one major enemy — acid. A high oral acid level brought on by over-consuming acidic foods and beverages or as a symptom of gastric reflux disease dissolves (de-mineralizes) the enamel’s mineral content. Brushing just after eating actually contributes to de-mineralization because the enamel is in a softer state. It requires forty-five minutes to an hour for your saliva to neutralize acid and restore minerals to the enamel — you may actually be brushing away enamel with this practice.
Once we know the underlying cause, we can use an appropriate method to reduce sensitivity. One way is to reduce nerve sensitivity in the dentin’s tubules or block them altogether. There are several chemical products for both home and dental office application that can reduce sensitivity and encourage enamel re-mineralization (as can the fluoride added to toothpaste). We can also strengthen enamel and provide a mechanical barrier to acid through concentrated fluoride in a varnish applied to tooth and root surfaces. And, life-like restorations like crowns or veneers not only improve the appearance of your teeth, they can also provide coverage for exposed dentin.
If you are experiencing painful sensitivity, make an appointment to visit us. Once we know the source, we can treat the problem and reduce your discomfort.
If you would like more information on tooth sensitivity and how to treat it, 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 “Treatment of Tooth Sensitivity.”
If you have chronic jaw pain, you know how difficult eating, speaking or even smiling can be. Many sufferers will do anything to gain relief, even surgery. But before you go down that road, consider the traditional conservative approach to temporomandibular disorders (TMD) management first—it could provide the most relief with the least risk of side effects.
The temporomandibular joints connect the lower jaw to the skull on either side of the head. These ball and socket joints also contain a cushioning disk to facilitate movement. This disk is believed to be the primary focus for jaw pain problems known collectively as TMD.
Doctors now believe injury, stress, metabolic issues, jaw anatomy defects or similar factors trigger the chain reaction of muscle spasms, pain and soreness that can erupt during a TMD episode. A TMD patient may experience pain within the jaw muscles or joints themselves, clicking sensations, or an inability to open the jaw to its full range.
TMD therapy has traditionally followed an orthopedic path—treating jaw joints like any other joint. In recent years, though, a more aggressive treatment model has emerged that promotes more invasive techniques like orthodontics, dental work or jaw surgery to relieve discomfort. But the track record for this model, especially concerning jaw surgery, remains hazy at best and offers no guarantee of relief. These techniques are also irreversible and have even made symptoms worse in some patients.
It’s usually prudent, then, to try conservative treatments first. This can include pain and muscle relaxant medication, jaw exercises, stretching and massage, and dietary changes to reduce chewing force. Patients with teeth grinding habits may also benefit from a bite guard worn at night to reduce the biting force during sleep and help the joints relax.
By finding the right mix of treatments, you may be able to find significant relief from TMD symptoms with the conservative approach. If not, you might then discuss more invasive options with your dentist. But even if your dentist recommends such a procedure, you would be wise to seek a second opinion.
TMD can definitely interfere with your quality of life and peace of mind. But there are ways to reduce its effects and make for a happier life.
If you would like more information on managing chronic jaw 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 “Seeking Relief from TMD.”
Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”
Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.
Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:
A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.
If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.
Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.
Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.
Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.
If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”