Posts for: November, 2020
Pain can tell you things. Not verbally, of course, as in, “Hey, your appendix is inflamed!” But the quality of your pain—dull or sharp, constant or intermittent, acute or general—can point the way to the actual problem.
That's especially true of tooth pain, which could signal any number of dental problems. Looking at its characteristics, though, can narrow the search. Here are a few examples.
Sharp, momentary pain. This could be an indication of a number of possible dental problems. If it occurs for a few seconds after eating or drinking something hot or cold, it might signal a small area of tooth decay, a loose filling or early signs of gum recession. The latter could be a symptom of periodontal (gum) disease, so you should seek diagnosis and treatment as soon as possible.
Sharp pain when biting. Like tooth sensitivity, this could be a sign of decay or a loose filling, or it could indicate a fractured (cracked) tooth. If it's the latter, you may need an endodontist, a specialist in interior tooth problems, if you want the best chance for saving the tooth.
Dull ache in upper teeth. This might not be a dental problem at all, but radiating pain from an infection of the sinus just above the upper posterior teeth. The infection could also have begun with one of the molar teeth and advanced into the sinus. You'll need to see your dentist for any teeth or gums involved and possibly a physician to address any potential sinus infection.
Constant throbbing pain. That horrible toothache that won't stop could be the nerves in the tooth's interior under attack from decay. The primary means for saving a tooth with deep decay is a root canal treatment to clean out diseased tissue and replace it with a filling or a crown. You should see a dentist even if the pain suddenly subsides—this may only mean the nerves have died, but the infection is still active.
These are just a few of the problems, including true dental emergencies, that oral pain can signal. For any instance of pain in your mouth, see your dentist as soon as possible.
If you would like more information on tooth pain and what it might indicate, 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!”
Before implants, people often turned to a removable appliance to replace multiple missing teeth. Known as a removable partial denture (RPD), this appliance could restore both appearance and function at an affordable price.
But although implants may have diminished their use, RPDs haven't gone extinct. They're still a viable option for patients who can't afford implants or fixed bridgework, or who can't obtain implants due to the state of their dental health.
Although replacing only a few teeth rather than an entire arch, RPDs are similar in basic concept to full dentures. The prosthetic (artificial) teeth are anchored in a resin or plastic that's colored to resemble the gums, precisely placed to fit into the missing gaps. This assembly is further supported by a frame made of vitallium, a lightweight but strong metal alloy. The appliance fits upon the arch with the missing teeth, supported by vitallium clasps that grip adjacent natural teeth.
Each RPD must be custom designed for each patient to fit perfectly without excessive movement during chewing. Too much movement could warp the fit, reduce the RPD's durability or damage other teeth. To achieve this secure fit, dentists must take into account the number and location of missing teeth to be replaced, and then apply a specific construction pattern to balance the appliance.
There are RPDs that are meant to be used short-term, as with a teenager whose jaw isn't yet mature for dental implants. But the metal-framed RPDs we've described are designed for long-term use. There is, however, one primary downside: RPDs have a propensity to collect dental plaque, a thin biofilm most responsible for dental disease that could further deteriorate your dental health.
To avoid this, you'll need to keep both the RPD and the rest of your teeth and gums as clean as possible with daily brushing and flossing, and appliance care. And like dentures, it's best to remove the RPD when you go to bed at night to discourage the growth of harmful bacteria.
To see if an RPD to replace your missing teeth is an option for you, visit us for a complete dental exam. From there, we can advise you further as to whether an RPD could affordably restore your missing teeth and your smile.
If you would like more information on RPDs, 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 “Removable Partial Dentures.”
Heartburn is a big problem: Each year we Americans spend around $10 billion on antacid products, twice as much as for over-the-counter pain relievers. It's an even bigger problem because many indigestion sufferers actually have acid reflux or GERD (gastroesophageal reflux disease), a chronic disease that can cause physical harm—including to teeth.
That's why we've joined with other healthcare providers for GERD Awareness Week, November 17-23, to call attention to the causes and consequences of this disease. In addition to the harm it poses to the esophagus (the “tube” leading from the mouth to the stomach through which food passes), GERD could also damage your teeth to the point of losing them.
GERD is usually caused by the weakening of the lower esophageal sphincter, a ringed muscle located at the junction between the esophagus and the stomach. It acts as a “one-way valve” allowing food into the stomach, but not back into the esophagus. If it weakens, powerful stomach acid can come back into the esophagus and possibly even the mouth. The latter scenario poses a danger to teeth's protective layer of enamel.
Although tough and durable, enamel softens after prolonged contact with acid. Oral acid isn't all that unusual—acid levels typically rise right after eating, causing a temporary softening of enamel. Our saliva, however, goes to work to bring down those acid levels and stabilize enamel.
But if stomach acid enters the mouth because of GERD, the increased acidity can overwhelm saliva's ability to neutralize it. This can lead to enamel erosion, tooth decay and ultimately tooth loss. The enamel damage can be so pronounced that dentists are often the first to suspect GERD.
If you're diagnosed with GERD, here's what you can do to protect your teeth.
- Manage your GERD symptoms through medication, avoidance of spicy/acidic foods, alcohol, caffeine or tobacco products, and maintaining an optimum weight;
- Stimulate saliva by drinking more water, using saliva boosters, or (with your doctor's consent) changing from medications that may be restricting saliva flow;
- Speak with your dentist about strengthening your enamel with special toothpastes or mouthrinses containing extra fluoride or amorphous calcium phosphate (ACP).
You should also brush and floss daily to lower your risk of dental disease, but with one caveat: Don't brush your teeth during or immediately after a reflux episode, as you might remove microscopic bits of softened enamel. Instead, rinse your mouth with water mixed with a half-teaspoon of baking soda (an acid neutralizer) and wait about an hour to brush. The extra time also gives saliva time to further neutralize any remaining acid.
GERD can be unpleasant at best and highly destructive at worst. Don't let it ruin your teeth or your smile.
If you would like more information about GERD and dental health, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “GERD and Oral Health” and “Dry Mouth.”