“My tooth hurts…or maybe more than one. Or, it might be my gums.”
If you're having trouble describing the pain in your mouth, don't feel bad. Although our body's pain mechanism is great for alerting us to a problem, it can't always tell us the true cause and location of that problem.
That's especially true of tooth pain. It could be a sign, for instance, of decay within a tooth's inner pulp. When under attack, the nerves in the pulp often send out pain signals that could be sharp, dull, continuous, intermittent, seeming to come from one tooth or several.
If this is the case, depending on how deep the decay is, you could need a filling to resolve the problem or, if it's more extensive, possibly a root canal treatment to save the affected tooth. If you need a root canal, after removing the pulp's diseased tissue, the procedure calls for filling the empty pulp chamber and root canals to prevent future infection.
Another possibility for the pain is gum disease that has also infected the tooth. Gum disease usually begins with the bacteria in dental plaque, a thin biofilm that builds up on tooth surfaces, which infect the gums. If not treated promptly, the infection can advance below the gum line to the tooth roots and supporting bone. From there, it could invade the tooth and travel through the root canals to the interior pulp.
In this scenario, we'll need to treat the gum disease by removing plaque and tartar (hardened plaque) deposits from all tooth and gum surfaces. This is usually done manually with hand instruments or ultrasonic equipment, but it may also require surgical access to infected areas around the roots. If the tooth's nerve has become involved, we may also need to perform a root canal treatment as described above.
There are three key points to take from these two tooth pain scenarios. First, the only way to determine the true cause of your pain (and what treatment you'll need) is with a dental exam. Second, the sooner your pain is diagnosed and you begin treatment, the better your outcome—so see your dentist at the first sign of pain or other symptoms like swollen or bleeding gums.
And finally, you may be able to prevent these and other dental problems by removing disease-causing plaque through daily brushing and flossing and professional teeth cleaning every six months. Prevention through effective oral hygiene may help you avoid a future bout of mysterious tooth 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're a parent, raising kids can be a great adventure. It can also rev up your stress meter in a heartbeat. One area in particular can give you heartburn: your child's lack of enthusiasm for visiting the dentist.
Dental anxiety in varying degrees in children isn't uncommon. At times, it can be difficult for everyone involved for a child to receive the dental care they need if they're in an upset or agitated state. Fortunately, though, there are things you can do to minimize your child's dental anxiety.
First, start regular dental visits as early as possible, usually around their first birthday. Children who begin seeing the dentist earlier rather than later are more apt to find the sights, sounds and other experiences of a dental office a routine part of life.
You might also consider using a pediatric dentist for your child. Pediatric dentists specialize in child dental care, and have specific training and experience interacting with children. Pediatric dental offices are also usually “kid friendly” with toys, videos, books and interior decorations that children find appealing.
Your attitude and demeanor during a dental visit can also have an effect on your child. Children in general take their cues for how to feel from their caregivers. If you're nervous and tense while with them at the dentist, they may take that as a sign they should feel the same way. In contrast, if you're calm and relaxed, it may help them to be calm and relaxed.
Along the same lines, your attitude and level of commitment to dental care, both at home and at the dentist, will rub off on them. The best way to do that is by setting the example: not only as you brush and floss every day, but during your own dental visits. Take them with you: If they see you're not anxious about your care, it may improve their own feelings about their care.
The main goal is to try to make your child's overall dental experience as positive and pleasant as possible. The benefits of this can extend far beyond the present moment into their adult lives.
If you would like more information on your child's dental care, 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 “Taking the Stress Out of Dentistry for Kids.”
Bad news at your last dental visit: You have a decayed tooth. And not just in the enamel—the decay has invaded the tooth's inner pulp and the resulting infection is threatening the supporting bone structure.
You're thinking that tooth is toast. Then comes the good news: your dentist believes the tooth can be rescued with a root canal treatment.
But then you begin thinking about how often Uncle Sid says he'd rather undergo a colonoscopy than have a root canal. Is the procedure really as painful and uncomfortable as popular culture says it is? What is a root canal really like?
First step: Things go numb. Uncle Sid is wrong: A root canal treatment is painless because your dentist will first make sure the entire area involving the tooth is anesthetized. This does involve injecting the local anesthetic deep within the tissues, but you won't even feel the needle prick thanks to topical anesthesia applied to the surface gums.
Second step: Drilling deep. After applying a protective dam to isolate the infected tooth from its neighbors, your dentist will drill a small access hole through the enamel and dentin to reach the pulp and root canals. If it's one of the larger back teeth, the access hole is usually drilled in the tooth's biting surface; in a front tooth, the hole is usually located on the tongue side.
Third Step: Removing diseased tissue. Using special instruments, your dentist will remove the diseased tissue in the pulp and root canals, essentially stopping the infection and any tooth pain you've been experiencing. The empty pulp chamber and canals are often then disinfected with a special antibacterial solution.
Fourth Step: Protecting the tooth. After some shaping, the pulp chamber and root canals are filled with a special filling to prevent further infection. The access hole is then filled and sealed to complete the procedure. At some point in the future, the tooth typically will need a crown to add support and further protection.
You may have some minor discomfort afterward, but this can usually be managed with a mild pain reliever like ibuprofen or acetaminophen. After a week or so, you'll be good as new—and so will your tooth.
If you would like more information on root canal therapy, 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 “A Step-By-Step Guide to Root Canal Treatment.”
As the host of America's Funniest Home Videos on ABC TV, Alfonso Ribeiro has witnessed plenty of unintentional physical comedy…or, as he puts it in an interview with Dear Doctor–Dentistry & Oral Health magazine, "When people do stuff and you're like, 'Dude, you just hurt yourself for no reason!'" So when he had his own dental dilemma, Alfonso was determined not to let it turn onto an "epic fail."
The television personality was in his thirties when a painful tooth infection flared up. Instead of ignoring the problem, he took care of it by visiting his dentist, who recommended a root canal procedure. "It's not like you wake up and go, 'Yay, I'm going to have my root canal today!'" he joked. "But once it's done, you couldn't be happier because the pain is gone and you're just smiling because you're no longer in pain!"
Alfonso's experience echoes that of many other people. The root canal procedure is designed to save an infected tooth that otherwise would probably be lost. The infection may start when harmful bacteria from the mouth create a small hole (called a cavity) in the tooth's surface. If left untreated, the decay bacteria continue to eat away at the tooth's structure. Eventually, they can reach the soft pulp tissue, which extends through branching spaces deep inside the tooth called root canals.
Once infection gets a foothold there, it's time for root canal treatment! In this procedure, the area is first numbed; next, a small hole is made in the tooth to give access to the pulp, which contains nerves and blood vessels. The diseased tissue is then carefully removed with tiny instruments, and the canals are disinfected to prevent bacteria from spreading. Finally, the tooth is sealed up to prevent re-infection. Following treatment, a crown (cap) is usually required to restore the tooth's full function and appearance.
Root canal treatment sometimes gets a bad rap from people who are unfamiliar with it, or have come across misinformation on the internet. The truth is, a root canal doesn't cause pain: It relieves pain! The alternatives—having the tooth pulled or leaving the infection untreated—are often much worse.
Having a tooth extracted and replaced can be costly and time consuming…yet a missing tooth that isn't replaced can cause problems for your oral health, nutrition and self-esteem. And an untreated infection doesn't just go away on its own—it continues to smolder in your body, potentially causing serious problems. So if you need a root canal, don't delay!
If you would like additional information on root canal treatment, please contact us or schedule a consultation. You can learn more by reading the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: What You Need to Know.”
If you know anything about dental disease, then you know bacteria ranks high on the Usual Suspects list. Tooth decay gets its start from acid produced by bacteria; periodontal (gum) disease is often triggered by bacteria that infect the gums.
But the particular strains of bacteria that can cause dental disease are a small percentage of the 10,000-plus species inhabiting your mouth. The rest, numbering in the millions, are fairly benign—and some, as recent research is now showing, play a sizeable role in protecting your teeth and gums against other malicious bacteria, fungi and viruses.
Dr. Aaron Weinberg, a dental researcher at Case Western Reserve University, has been investigating these protective bacteria for many years. His research began with a scientific conundrum: although the mouth has one of the highest densities of bacterial populations, wounds in the mouth tend to heal quickly.
The answer, he believes, originates with human beta defensins (hBDs), substances produced by cells in the lining of the mouth that are natural antibiotics against disease. He has found that certain bacteria actually help stimulate their production.
This isn't just an interesting fact about the body's defenses and immune system. During his research, Dr. Weinberg was able to identify the agent within the bacteria that triggered hBD production. This has opened up a new line of research: The possibility that harnessing this agent might help assist in our treatment of infection by boosting the body's defensive capabilities.
For example, researchers have proposed including a form of the agent in toothpaste. Over time, this might stimulate hBD production and guard the mouth against the development of dental diseases like gum disease.
These possibilities all come from our increasing knowledge and understanding of the microscopic world around us, especially in our mouths. Bacteria are much more complex than we may have realized—not all are our enemies, and some are definitely our friends. Learning more may open up new ways to keep our teeth and gums healthy.
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