Posts for: April, 2013
Is it a root canal problem, a gum infection, or both?
Sometimes it's difficult to pinpoint the source of tooth pain; it can result from an infection of the tooth itself, or of the gum, or even spread from one to the other. Identifying the origin of a toothache is important, however, so we can choose the right treatment and do all that we can to save the tooth.
When a tooth becomes decayed, bacteria can infect the sensitive, living nerve tissue deep inside the tooth known as the root canal. This condition is called an endodontic (“endo” – inside; “dont” – tooth) problem. The infection inside the tooth can spread to the periodontal ligament (“peri” – around; “dont” – tooth) that encases the tooth and attaches it to the jawbone. Occasionally, infection of endodontic (root canal) origin can spread out from the end of the tooth root all the way up the periodontal ligament, and into the gum.
The reverse can also happen: dental pain can originate from periodontal (gum) tissues that have become diseased. Gum disease is caused by a buildup of bacterial biofilm (plaque) along the gum line. It results in detachment of the gums along the tooth surface. In advanced cases, this bacterial infection can travel into the nerve tissues of the dental pulp through accessory canals or at the end of a tooth.
To figure out where pain is coming from when the source is not obvious, we need to take a detailed history of the symptoms, test how the tooth reacts to temperature and pressure, and evaluate radiographs (x-ray pictures).
Unfortunately, once dental disease becomes a combined periodontal-endodontic problem, the long-term survival of the tooth is jeopardized. The chances for saving the tooth are better if the infection started in the root canal and then spread to the gums, rather than if it started as gum disease that spread into the root canal of the tooth. That's because in the latter case, there is usually a lot of bone loss from the gum disease. Effectively removing plaque from your teeth on a daily basis with routine brushing and flossing is your best defense against developing gum disease in the first place.
If you would like more information about tooth pain, gum disease or root canal problems, please contact us or schedule an appointment for a consultation. You can also learn more about this diagnostic dilemma by reading Dear Doctor magazine's article “Confusing Tooth Pain.”
Do you snore? You can admit it. Most everyone does, from time to time. But if snoring becomes a frequent and disturbing feature of your nighttime routine, it may be more than just an annoyance. Did you know that excessive snoring — when accompanied by irritability and depression, daytime sleepiness and confusion, and/or several other physical and mood problems — is one of the common symptoms of a sleep-related breathing disorder (SRBD)?
SRBDs are potentially serious conditions, with consequences that can range from poor workplace performance to possible cardiovascular and brain damage. One of the most significant of these maladies is called Obstructive Sleep Apnea, or OSA, a condition in which the tongue and surrounding soft tissues fall back into the throat and obstruct air flow. This reduces oxygen levels in the blood, causing the body to wake suddenly — and in severe cases, it can happen up to 50 times an hour, without a person consciously realizing it.
Needless to say, that doesn't make for a good night's sleep. But even if it turns out your snoring problem isn't severe OSA, it can still prevent you (and your partner) from feeling refreshed in the morning. Did you know that we may be able to recommend an oral appliance that has been proven to alleviate problem snoring in many cases? This custom-made device, worn while you're sleeping, helps maintain an open airway in the throat and reduce breathing problems.
If you have this condition, it's critical that you get professional advice. Dentists who have received special training in sleep problems can evaluate you, provide medical referrals when needed, and help determine the type of appliance that may work best for you. Since sleep disorders can be problematic, a thorough evaluation and follow-up monitoring is essential.
Several treatments for SRBDs are available. But oral appliance therapy, when it's recommended, offers some distinct advantages. The small appliances are comfortable, easy to wear, and very portable — unlike more complex medical devices such as CPAP machines. They're a non-invasive and reversible treatment that should be considered before undertaking a more intensive treatment, like surgery. Could an oral appliance benefit you? Why not ask us if we can help you get a good night's sleep.
If you would like more information about oral appliance therapy for sleep problems, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Sleep Apnea FAQs.”
You use toothpaste every day — don't you? But how much do you really know about what's inside the tube: namely, the white, sticky stuff that keeps your teeth clean and your breath fresh? Take this True/False quiz and find out!
True of false: Powdered charcoal, brick dust and crushed bones were once ingredients in toothpaste. TRUE
Many years ago, these gritty abrasive materials were used to make toothpaste. Today, abrasives are still used — but they're much gentler. Compounds like hydrated silica or alumina, calcium carbonate, and dicalcium phosphate have proven effective at cleaning and polishing tooth surfaces without damaging the enamel.
True of false: Fluoride was first introduced into toothpaste in 1955. FALSE
Arguably toothpaste's most important ingredient, fluoride was used as early as 1914. But its mass-marketing debut came with the Crest brand in the mid-1950s. Today, no toothpaste without fluoride can receive the American Dental Association's Seal of Approval. That's because it has been shown to strengthen tooth enamel and help prevent tooth decay.
True of false: Detergent is a common ingredient of toothpaste. TRUE
But it isn't the same kind you do laundry with. Detergents — also called surfactants, because they act on the surfaces of liquids — help to loosen and break down deposits on your teeth, which can then be rinsed away. Like other health and beauty products, many toothpastes use a gentle detergent, derived from coconut or palm kernel oil, called sodium lauryl sulfate.
True of false: Whitening toothpastes work, to some degree, on all stains. FALSE
Whether the whitening agents in toothpaste will work for you depends on why your teeth don't look white in the first place. The abrasives and enzymes in these toothpastes can help remove “extrinsic” stains: those on the surface of your teeth. But for “intrinsic” stains — that is, internal discoloration — they probably won't help. In that case, you may need to get professional bleaching treatments.
True of false: Toothpastes made for sensitive teeth have substances that block pain transmission. TRUE
Potassium nitrate and strontium chloride can block the sensation of pain that may occur when dentin — the material that makes up most of the inside of teeth, and is normally covered by enamel — becomes exposed. Fluoride, too, helps reduce sensitivity. But the benefits of reduced tooth sensitivity may take a few weeks to really be felt.
If you have questions about toothpastes or oral hygiene, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine article “Toothpaste — What's In It?”
Bad breath, medically known as halitosis (“halitus” – breath; “osis” – disorder) is an unpleasant condition that can negatively impact your personal and business relationships. It's more than just embarrassing! In fact, one recent survey found that three out of five people would rather work with someone who talks too loudly than with someone who has bad breath! Gum, mints and mouth rinses can temporarily remedy the situation, but not cure it permanently. So how much do you know about the underlying causes of bad breath?
The following true/false quiz will help you discover, while learning more about bad breath.
- The most common orally related sites associated with bad breath are the tongue and gums.
- Systemic (general body) medical conditions can't cause bad breath.
- Bad breath is always worse in the morning.
- Effective treatment depends on the underlying cause of the disease.
- Dentists can do very little to diagnose the cause of bad breath.
- True. The back of the tongue and diseased gums can become repositories for bacteria. In the case of the tongue they are from left over food deposits and even post-nasal drip. Bad breath that emanates from the tongue has a “rotten egg” odor caused by volatile sulfur compounds (VSCs).
- False. Medical conditions can cause bad breath including lung infections, liver disease, diabetes, kidney infections and cancer.
- True. Saliva flow decreases during the night making the mouth feel dry, and giving you that typical “morning breath” taste and odor upon wakening.
- True. As with any medical condition, uncovering the origin will dictate appropriate treatment. For example, tongue scraping or brushing can help eliminate odor that originate from the tongue. If the cause is disease related, the disease will need to be treated to control associated bad breath.
- False. There are several things dentists can do starting with a thorough medical history and oral examination. For example, decayed or abscessed teeth, diseased gums, coated tongue or infected tonsils are all common oral causes. We can also conduct breath tests to determine if the odor is emanating from the mouth or lungs, and test to determine the level of VSCs in the mouth.
Worried about bad breath? Are you ready to trade your breath mints for a more permanent solution? Call our office today to schedule an oral examination. For more information about the causes of bad breath, read the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”