Posts for category: Oral Health
Not all toothaches are alike: Some are sharp and last only a second or two; others throb continuously. You might feel the pain in one tooth, or it could be more generalized.
Because there are as many causes as there are kinds of dental pain, you can expect a few questions on specifics when you come to us with a toothache. Understanding first what kind of pain you have will help us more accurately diagnose the cause and determine the type of treatment you need.
Here are a few examples of dental pain and what could be causing it.
Temperature sensitivity. People sometimes experience a sudden jolt of pain when they eat or drink something cold or hot. If it only lasts for a moment or two, this could mean you have a small area of tooth decay, a loose filling, or an exposed root surface due to gum recession. If the pain lingers, though, you may have internal decay or the nerve tissue within the tooth has died. If so, you may require a root canal treatment.
Sharp pain when chewing. Problems like decay, a loose filling or a cracked tooth could cause pain when you bite down. We may be able to solve the problem with a filling (or repair an older one), or you may need more extensive treatment like a root canal. In any event, if you notice this as a recurring problem, don't wait on seeing us—the condition could worsen.
Dull pain near the jaw and sinuses. Because both the jaws and sinuses share the same nerve network, it's often hard to tell where the pain or pressure originates—it could be either. You may first want to see us or an endodontist to rule out tooth decay or another dental problem. If your teeth are healthy, your next step may be a visit with a physician to examine your sinuses.
As you can see, tooth pain can be a sign of a number of problems, both big and small. That's why it's important to see us as soon as possible for an examination and diagnosis. The sooner we can treat whatever is causing the pain, the sooner your discomfort will end.
If you would like more information on treating dental 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 “Tooth Pain? Don't Wait!”
Controlling discomfort during dental work is one of our top priorities. Advances in anesthesia over the last century have made that objective easier to attain, especially for routine procedures.
The term anesthesia means “without feeling or pain.” It refers to the use of substances to prevent a patient’s nervous system from sensing pain. There are two basic types: general, through intravenous injection (IV) or gas inhalation that places a patient in an unconscious state; and local, which only affects the part of the body involved in the procedure while the patient remains conscious.
The latter type has become very important in dentistry, especially for mild to moderate procedures. Because teeth and gum tissues are rich in nerves, patients can have a heightened level of sensitivity that can increase anxiety and discomfort during dental work. Local anesthesia reduces that discomfort and relaxes both patient and dental provider.
We typically administer local anesthesia in two ways: by applying the anesthetic to the outside tissue surface (with a cotton swab, patch or spray) or by injection. The first type, topical anesthesia, is most often used to eliminate the pricking discomfort of the needle used to inject the main anesthetic. Using both applications eliminates any painful sensation at all — the only thing you might feel is a slight pressure during the procedure.
As mentioned before, local anesthesia benefits us as well as you. Knowing you’re at ease and comfortable allows us to better focus on the procedure — we’re not rushed to finish to spare you further discomfort. A relaxed, unhurried atmosphere is essential to a successful outcome for any dental procedure.
We’ve also found solutions for another issue with local anesthesia that concerns patients: the length of time the numbing effect lingers after a procedure. In response, the dental profession has developed different types of anesthesia that reduce this after effect considerably. We’re also more selective about what procedures actually require anesthesia — some, like routine teeth cleaning or work on the outer enamel (which doesn’t contain nerves), can usually be performed without it.
All in all, local anesthesia reduces your level of discomfort and increases our ability to be thorough in performing your dental work. You’ll not only find the experience more pleasant, but it will also enhance the quality of your care.
If you would like more information on alleviating pain and discomfort during dental work, 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 “Local Anesthesia for Pain-Free Dentistry.”
Forty years have passed since the first reported case of Acquired Immune Deficiency Syndrome (AIDS), and it and the human immunodeficiency virus (HIV) that causes it are still with us. About 1.2 million Americans are currently infected with HIV, with 50,000 new cases diagnosed each year.
The emergence of antiretroviral drugs, though, has made it possible for many with HIV to live normal lives. Even so, the virus can still have a profound effect on health, including the teeth and gums. Because of its effect on the immune system, HIV+ patients are at greater risk for a number of oral conditions, like a fungal infection called candidiasis ("thrush").
Another common problem is chronic dry mouth (xerostomia), caused by a lack of saliva production. Not only does this create an unpleasant mouth feel, but the absence of saliva also increases the risk for tooth decay and periodontal (gum) disease.
The latter can be a serious malady among HIV patients, particularly a severe form of gum disease known as Necrotizing Ulcerative Periodontitis (NUP). With NUP, the gums develop ulcerations and an unpleasant odor arising from dead gum tissue.
Besides plaque removal (a regular part of gum disease treatment), NUP may also require antibiotics, antibacterial mouthrinses and pain management. NUP may also be a sign that the immune system has taken a turn for the worse, which could indicate a transition to the AIDS disease. Dentists often refer patients with NUP to a primary care provider for further diagnosis and treatment.
Besides daily brushing and flossing, regular dental cleanings are a necessary part of a HIV+ patient's health maintenance. These visits are also important for monitoring dental health, which, as previously noted, could provide early signs that the infection may be entering a new disease stage.
It's also important for HIV+ patients to see their dentist at the first sign of inflamed, red or bleeding gums, mouth lesions or loose teeth. Early treatment, especially of emerging gum disease, can prevent more serious problems from developing later.
Living with HIV-AIDS isn't easy. But proper health management, including for the teeth and gums, can help make life as normal as possible.
If you would like more information on dental care and HIV-AIDS, 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 “HIV-AIDS & Oral Health.”
In addition to the usual tooth and gum problems, dentists also see patients with soft tissue infections in and around the mouth. One of the more common of these is the irritation or "cracking" of the corners of the mouth.
Formally known as angular cheilitis (or perleche, a French word, meaning "to lick"), cracked mouth corners are localized irritations made worse by saliva accumulation or an accompanying yeast infection. They're prominent among children and young adults who drool during sleep or while wearing orthodontic braces.
Older adults can also develop cracked mouth corners because of deep wrinkle lines around the mouth ("marionette lines") or tissue irritation from wearing dentures. Teeth loss, especially in the back of the jaws, can weaken facial support leading to collapse of the bite, which can contribute to angular cheilitis.
The condition can cause anything from minor discomfort at the mouth corners to a yeast infection that spreads throughout the mouth and throat. Whatever the symptoms, treatment usually begins with antifungal medication in the form of a mouthrinse or a topical ointment. The dentist may also prescribe a steroid ointment like zinc oxide paste to control inflammation and serve as a barrier against infection.
If the infection has spread beyond the mouth corners, patients may also need to use an antibacterial mouthrinse (usually chlorhexidine) to clear up the infection and help prevent a relapse. Besides cleaning their appliances with chlorhexidine, denture wearers with angular cheilitis should also take their dentures out at night to reduce the chances of a reoccurrence.
Along the same vein, patients who contend with frequent cracked mouth corners and who have missing teeth should have those teeth replaced by some form of restoration. If that involves dentures, it's important to maintain a good fit with them to reduce the chances of tissue irritation. And patients with deep wrinkle lines around their mouth may be able to lessen them through dermatological treatment.
Even though cracked mouth corners rarely pose a major health problem, the discomfort they cause can be a drag on your daily life and activities. Remember that you don't have to suffer—a visit to your dentist could start you on your journey toward relief from this irritating problem.
If you would like more information on angular cheilitis and similar mouth conditions, 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 “Cracked Corners of the Mouth.”
There are few more painful experiences than a toothache. You can't ignore it: it's as if your mouth is screaming for relief.
But while the throbbing pain can tell you something's wrong, it may not be clear exactly what's wrong. There's more than one possibility — it could be with the tooth itself, the gums around the tooth or a combination of both.
In the first case, a toothache could be a sign of severe tooth decay within the tooth's innermost layer, the pulp. The pain you feel comes from the nerves within the pulp under attack from the infection.
For this level of decay there's one primary way to save the tooth and stop the pain: a root canal treatment. In this procedure we remove all the infected and dead tissue from the pulp and fill the empty chamber and root canals with a special filling. We then seal and crown the tooth to prevent further infection.
Another source of toothache happens when your gums have become painfully inflamed due to infection. This is usually caused by periodontal (gum) disease, triggered by a thin film of bacteria and food particles on tooth surfaces known as plaque. In this case, we must remove all plaque and calculus (hardened plaque deposits) from tooth and gum surfaces, including on the roots. Your gums can then heal and return to health.
But your situation could be more complex. Untreated tooth decay can advance to the roots and subsequently infect the gums. Likewise advanced gum disease can pass the infection from the gums to the root and into the pulp.Â For such cases you may need a specialist, either an endodontist specializing in root canal issues or a periodontist specializing in the gums.Â They can better diagnose the origin and extent of the problem and offer advanced techniques and treatments to deal with it.
It's possible in these more complex situations your tooth has become diseased beyond repair and must be replaced. It's important, then, that you see us if you experience any significant tooth pain, even if it seems to go away. The sooner we diagnose and begin treating the cause of your pain, the better your chances of regaining your dental health.
If you would like more information on treating dental disease, 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.”