While mouth pain can certainly get your attention, what exactly hurts may be difficult to identify. It might seem to emanate from a single tooth, or a group of teeth. Then again, it might not be clear whether it's coming from teeth or from the gums.
Still, it's important to pinpoint the cause as much as possible to treat it correctly. One of the main questions we often want to answer is whether the cause originates from within a tooth or without.
In the first case, tooth decay may have entered the pulp at the center of the tooth. The pulp contains nerve bundles that can come under attack from decay and transmit pain signals. Incidentally, if the pain suddenly goes away, it may simply mean the nerves have died and not the infection.
The decay can also spread into the root canals leading to the root and supporting bone, and then make the jump into the gum tissues. One possible sign of this is the one mentioned earlier—you can't quite tell if the pain is from the tooth or the surrounding gums.
The root canals could also serve as a transportation medium for infection in the other direction. In that case, gum disease has advanced into the bone tissues around a tooth near its roots. The infection can then cross into the tooth. Again, both a tooth and the gum tissue around it can become diseased.
We have effective treatments for individual occurrences of interior tooth decay or gum disease: The former usually requires a root canal treatment to remove infected tissue and fill and seal the tooth from future infection; we alleviate gum disease by removing the dental plaque causing it and helping the gum tissues to heal. But combined tooth and gum infection scenarios are more difficult to treat, have a poorer prognosis and may require specialists.
To reduce the risk of either tooth decay or gum disease developing into this greater problem, it's best to take action at the first sign of trouble. So, see your dentist as soon as possible when you encounter oral pain or if you notice swollen or bleeding gums. The earlier we treat the initial outbreak of disease, be it tooth decay or gum disease, the better your chances of a successful and happy outcome.
If you would like more information on 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.”
It's normal to have occasional mouth dryness—that "cotton mouth" feeling when you first wake up or after eating a spicy meal. It soon dissipates, though, leaving you no worse for wear other than the memory of an unpleasant sensation.
For some, though, the unpleasant sensation becomes a chronic condition known as xerostomia, in which their mouth feels dry most of the time. And, it can have far-reaching consequences beyond a mere irritation if not treated.
Among the numerous causes for xerostomia, the most common appears to be over-the-counter and prescription medication. An estimated five hundred medications have dry mouth as a potential side-effect, from antihistamines to antidepressants. And because people over 65 are more likely to take medications, they also have a high occurrence of xerostomia.
A person with certain systemic diseases like Parkinson's Disease or undergoing radiation or chemotherapy for cancers of the head and neck may also encounter dry mouth. For example, an autoimmune disease called Sjögren's syndrome, primarily affecting postmenopausal women, can dry out the mouth's mucous membranes.
Chronic dry mouth isn't normal, and often a sign of a health problem that should be examined. And it can lead to more problems with your oral health. Because dry mouth is most likely a reduction in saliva, which helps buffer decay-causing acid and provides antibodies to fight bacteria, having less of this vital fluid can increase your risk for both tooth decay and gum disease.
So, what can you do if you're plagued by persistent dry mouth? If you suspect your medications may be a factor, talk with your doctor about whether one of them may be the underlying cause for your symptoms. You may be able to switch to an alternate medication without dry mouth side-effects.
You can also increase your water intake during the day, including drinking more before and after taking medication. And there are a number of products like the artificial sweetener xylitol found in gums and candies that can boost saliva. Your dentist may also be able to recommend products that increase saliva.
Above all, be sure you keep up daily brushing and flossing, as well as regular dental cleanings. Taking care of chronic dry mouth could help you avoid dental problems later.
If you would like more information on preventing and treating chronic dry mouth, 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 “Dry Mouth.”
In one respect, celebrities are no different from the rest of us—quite a few famous people love to collect things. Marie Osmond collects dolls (as well as Johnny Depp, reportedly); Leonardo DiCaprio, vintage toys. And, of course, Jay Leno has his famous fleet of cars. But Victoria Beckham's collection is unusually "familial"—she's kept all of her four children's "baby" teeth after they've fallen out.
Best known as Posh Spice of the 1990s group Spice Girls and now a fashion designer and TV personality, Beckham told People Magazine that she has an "entire bucket" of her kids' primary teeth. And, she recently added to it when her nine-year old daughter lost another tooth earlier this year.
You may or may not want to keep your child's baby teeth, but you'll certainly have the opportunity. Children start losing their first set of teeth around age 6 or 7 through early puberty. During the process, each tooth's roots and gum attachment weakens to the point that the tooth becomes noticeably loose. Not long after, it gives way and falls out.
Although a baby tooth doesn't normally need any help with this, children (and sometimes parents) are often eager to accelerate the process. A loose tooth can be annoying—plus there's often a financial incentive via the "Tooth Fairy!"
First off, there's not much harm in a child wiggling a loose tooth—it may even help it come out. It's also possible to help the tooth safely detach sooner by taking a small piece of tissue, folding it over the tooth and giving it a gentle downward squeeze. If it's loose enough, it should pop out.
If it doesn't, don't resort to more forcible measures like the proverbial string and a door—just wait a day or two before trying the gentle squeeze method again. Once the tooth comes out, the empty socket may bleed a bit or not at all. If heavy bleeding does occur, have the child bite down on a piece of clean gauze or a wet tea bag until it stops. You may also have them eat softer foods for a few days to avoid a resumption of bleeding.
Beyond that, there's little else to do but place it under your child's pillow for the Tooth Fairy. And if after their "exchange" with that famous member of the Fae Folk you find yourself in possession of the erstwhile tooth, consider taking a cue from Victoria Beckham and add it to your own collection of family memories.
Losing teeth can make it more difficult to eat, not to mention the effect it can have on your smile. But that could be just the beginning of your problems. Missing teeth can contribute to extensive bone loss within your jaws and face. Here's why.
Bone is like any other living tissue—cells develop, function and eventually die, and new cells take their place. Forces generated during chewing stimulate this new growth, helping the jawbone maintain its normal volume and density.
But you lose this stimulus when you lose teeth. This can cause a slowdown in bone cell regrowth that can eventually diminish bone volume. And it can happen relatively quickly: you could lose a quarter or more of jawbone width around a missing tooth within a year.
As this loss continues, especially in cases of multiple missing teeth, the bone can eventually erode to its base level. This loss of dental function can make chewing more difficult, place more pressure on the remaining teeth and adversely affect facial appearance. It could also prevent an implant restoration to replace missing teeth.
Dentures and other forms of dental restoration can replace missing teeth, but not the chewing stimulus. Dentures in particular will accelerate bone loss, because they can irritate the bony gum ridges they rest upon.
Dental implants, on the other hand, can slow or even stop bone loss. Implants consist of a metal post, typically made of titanium, imbedded into the jawbone at the site of the missing tooth with a life-like crown attached. Titanium also has a strong affinity with bone so that bone cells naturally grow and adhere to the implant's surface. This can produce enough growth to slow, stop or even reverse bone loss.
This effect may also work when implants are combined with other restorations, including dentures. These enhanced dentures no longer rest on the gums, but connect to implants. This adds support and takes the pressure off of the bony ridge, as well as contributes to better bone health.
If you've lost a tooth, it's important to either replace it promptly or have a bone graft installed to help forestall any bone loss in the interim. And when it's time to replace those missing teeth, dental implants could provide you not only a life-like solution, but a way to protect your bone health.
If you would like more information on dental implants, 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 “The Hidden Consequences of Losing Teeth.”
Besides straight and translucent teeth, an attractive smile has another important component: balance. In a great smile, the visible areas of the teeth and gums are in balanced proportion to one another.
But what is the ideal proportion between teeth and gums? Although aesthetic appeal is largely “in the eye of the beholder,” dental professionals typically consider a properly sized tooth to be around 10 mm in visible length. As for the upper gums, no more than 4 mm of tissue should show when smiling. Teeth appearing shorter than 10 mm or the gums displaying more than 4 mm can create an effect called a “gummy smile.”
Fortunately, there are different approaches for correcting a gummy smile, depending on what's causing the appearance of gumminess. Not only are there different causes, but they can be diverse in nature.
Obviously, an actual excess of gum tissue can cause a smile to look gummy—but so can shortened teeth. One possible solution called crown lengthening could help correct either possibility. During the procedure, we remove any excess gum tissue or reposition the gums after reshaping the underlying bone to reveal more of the tooth crown. Worn or shortened teeth can also be made to look longer with porcelain veneers.
A gummy smile could also be caused by a hypermobile lip, in which the lip rises higher than normal while smiling. We may be able to prevent this temporarily by injecting Botox into the lip muscles, which paralyzes them and inhibits their ability to move upward. A more permanent approach is to surgically restrict the upward movement of the lip muscles.
The gums may also seem too prominent if the upper jaw is longer in proportion to the face. One way to correct this is orthognathic surgery, a procedure that moves the upper jaw to a higher position on the skull. This can reduce the jaw profile with the face and subsequently affect how much of the gums show while smiling.
These solutions range from relatively minor to significantly invasive. The first step, though, is to find out what's really behind your gummy smile before taking the next step to make it more attractive.
If you would like more information on improving a gummy smile, 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 “Gummy Smiles.”
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