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.”
If you’ve lost some teeth you may eventually want to replace them with dental implants. Implants by far are the restoration of choice due to their life-likeness and durability. But those advantages don’t come cheaply — implants can be expensive especially for multiple teeth.
If you’re forced to wait financially for implants, you still have other intermediary options like a removable partial denture (RPD). The conventional RPD has a rigid acrylic base colored to resemble gum tissue supported by a metal frame with attached prosthetic (false) teeth at the missing teeth locations. They’re held secure in the mouth through metal clasps that fit over the remaining teeth.
But these conventional RPDs can sometimes be uncomfortable to wear and don’t always cover the bottom of the gum completely. If this is a concern, you might consider an alternative: flexible RPDs. The base of this RPD is made of a form of flexible nylon rather than acrylic plastic. They’re much more lightweight but still fit securely in the mouth with thin plastic extensions rather than metal clasps. The base can also be more easily formed to cover areas where gum tissue may have receded.
While flexible RPDs hold up better to wear and tear than their conventional counterparts, they must still be maintained like any other appliance. They can accumulate plaque (bacterial biofilm) responsible for tooth decay and periodontal (gum) disease, so daily thorough cleaning is a must. And if there fit becomes loose they can be more difficult to reline or repair than other types of dentures.
They also share a common weakness with other dentures — they can’t prevent and may even stimulate bone loss. As bone ages, old cells dissolve and new ones form to take their place. As we eat and chew our teeth transmit the forces generated through the teeth to the bone to stimulate it to grow. RPDs and other dentures can’t transmit this stimulus, so the bone replaces much slower to the point that the bone volume can diminish.
That’s why it’s best to consider any RPD as a temporary solution until you can obtain an implant for a more permanent and bone-friendly option. In the meantime, though, an RPD can provide you with a great solution for both form and function for missing teeth.
If you would like more information on RPD choices, 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 “Flexible Partial Dentures: An Aesthetic Way to Replace Teeth Temporarily.”
While lasers still seem like science fiction, they’ve been used commercially (and medically) for decades. But there’s still room for growth in practical applications with this developing technology. One promising area is in the treatment of periodontal (gum) disease.
Gum disease is a bacterial infection triggered by plaque, a thin film of bacteria and food particles caused by inadequate oral hygiene. The disease is highly destructive and can eventually lead to both tooth and bone loss. Treatment procedures vary widely, but they all have the same goal: remove the offending plaque and calculus (tartar) from tooth and gum surfaces. Without plaque the infection subsides and the gums can heal.
For decades now, dentists have removed plaque and calculus manually with special hand instruments or ultrasonic equipment. If the disease has advanced below the gum line or formed deep voids filled with infection called periodontal pockets, the dentist may also employ surgical techniques to access the infected areas.
While all these techniques have a long track record for effectiveness, they can cause the inadvertent destruction of healthy tissue, as well as create discomfort for some patients afterward. This is where a new protocol called Laser Assisted New Attachment Procedure (LANAP®) may be able to make a difference in the future.
With the LANAP® protocol, surgeons direct a laser beam of light through a fiber optic the width of three human hairs onto diseased tissue. The particular color of light interacts with the tissue, which contains the darkly-pigmented bacteria causing the disease, and “vaporizes” it. The beam, however, passes harmlessly through lighter-pigmented healthy tissue; as a result diseased tissue is eradicated with little to no harm to adjacent healthy tissue.
With these capabilities, trained dentists using LANAP® for gum disease treatment might be able to achieve conventional results with less tissue removal and bleeding, less discomfort for patients, and less tissue shrinkage than traditional procedures — and without scalpels or sutures. And some post-surgical studies have indicated LANAP® might also encourage gum tissue regeneration in the months following.
LANAP®, however, is still developing and requires further research. Thus far, though, the results have been encouraging. As laser technology advances, it’s quite possible tomorrow’s patient may experience less discomfort and more effective healing with their gum disease treatment.
If you would like more information on gum disease treatment, 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 “Treating Gum Disease with Lasers.”
Everyone knows that in the game of football, quarterbacks are looked up to as team leaders. That's why we're so pleased to see some NFL QB's setting great examples of… wait for it… excellent oral hygiene.
First, at the 2016 season opener against the Broncos, Cam Newton of the Carolina Panthers was spotted on the bench; in his hands was a strand of dental floss. In between plays, the 2105 MVP was observed giving his hard-to-reach tooth surfaces a good cleaning with the floss.
Later, Buffalo Bills QB Tyrod Taylor was seen on the sideline of a game against the 49ers — with a bottle of mouthwash. Taylor took a swig, swished it around his mouth for a minute, and spit it out. Was he trying to make his breath fresher in the huddle when he called out plays?
Maybe… but in fact, a good mouthrinse can be much more than a short-lived breath freshener.
Cosmetic rinses can leave your breath with a minty taste or pleasant smell — but the sensation is only temporary. And while there's nothing wrong with having good-smelling breath, using a cosmetic mouthwash doesn't improve your oral hygiene — in fact, it can actually mask odors that may indicate a problem, such as tooth decay or gum disease.
Using a therapeutic mouthrinse, however, can actually enhance your oral health. Many commonly available therapeutic rinses contain anti-cariogenic (cavity-fighting) ingredients, such as fluoride; these can help prevent tooth decay and cavity formation by strengthening tooth enamel. Others contain antibacterial ingredients; these can help control the harmful oral bacteria found in plaque — the sticky film that can build up on your teeth in between cleanings. Some antibacterial mouthrinses are available over-the-counter, while others are prescription-only. When used along with brushing and flossing, they can reduce gum disease (gingivitis) and promote good oral health.
So why did Taylor rinse? His coach Rex Ryan later explained that he was cleaning out his mouth after a hard hit, which may have caused some bleeding. Ryan also noted, “He [Taylor] does have the best smelling breath in the league for any quarterback.” The coach didn't explain how he knows that — but never mind. The takeaway is that a cosmetic rinse may be OK for a quick fix — but when it comes to good oral hygiene, using a therapeutic mouthrinse as a part of your daily routine (along with flossing and brushing) can really step up your game.
Porcelain crowns have been used to restore problem teeth since at least the early 20th Century. Crown technology has gradually progressed from the early use of precious metals like gold or silver to more life-like porcelain crowns, often with a metal interior for added strength. Today, most crowns are all-porcelain, made with newer materials that not only look attractive but can endure under the pressures of daily chewing or biting.
While crowns are often part of restorations for missing teeth, they’re also commonly used to cap or fit over a viable tooth with structural or appearance problems. Here are 4 situations where a crown could improve a tooth’s form and function.
Traumatized teeth. A significant blow to the face or mouth could generate enough force to chip away or fracture a significant amount of structure from a tooth. If the root remains healthy and firmly attached within the jaw, however, a crown can replace the missing structure and restore the tooth’s function and appearance.
Root canal treatments. Root canal treatments remove infected or dead tissue within a tooth’s pulp chamber, its inner core, and the root canals. The procedure rescues the tooth but can in the process significantly alter the tooth’s structure and appearance. A crown not only restores the tooth but also provides added protection against further decay or tooth fracture.
Teeth with multiple fillings. We can effectively treat cavities caused by tooth decay by filling them. But with each filling we must remove more of the decayed structure and shape the cavity to accommodate the filling. After a number of times, a tooth may not have enough structure left to support another filling. If the tooth is still viable, a crown could solve this dilemma.
Abnormally developed teeth. Teeth sometimes don’t erupt in the jaw as they should and may be only partly visible. The tooth not only looks out of place but it can’t fully function like a normal tooth. Capping an abnormally developed tooth with a crown will help normalize it and allow it to blend in with surrounding teeth.
If you would like more information on crown restorations, 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 “Crowns & Bridgework.”
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