Posts for: May, 2016
What should you do if your child complains about a toothache? Before calling our office, try first to learn what you can about the toothache.
You should first ask them where exactly the pain is coming from — one particular tooth or a generalized, dull ache. Also try to find out, as best they can tell you, when they first noticed the pain. Try then to look at the tooth or area where they indicate the pain is coming from: since tooth decay is a prime cause for tooth pain, you should look for any obvious signs of it like brown spots or cavities. You should also look at the gums around the teeth for any redness or swelling, a sign of an abscess or periodontal (gum) disease.
If you notice any of these signs, the pain persists for more than a day, or it has kept the child awake during the night, you should have us examine them as soon as possible. If you notice facial swelling or they’re running a fever, please call and we will see them immediately. If it’s definitely tooth decay, it won’t go away on its own. The longer we wait to treat it, the worse its effects in the mouth.
In the meantime, you should also try to alleviate the pain as best you can. If when looking in the mouth you noticed food debris (like a piece of hard candy) wedged between the teeth, try to gently remove it with dental floss. Give them ibuprofen or acetaminophen in an appropriate dosage for their age to relieve pain, or apply an ice pack on and off for about 5 minutes at a time to the outside of their jaw.
If any of these remedies stops the pain within an hour, you can wait until the next day to call for an appointment. If the pain persists, though, then an abscess could be developing — you should call that day to see us.
Regardless of when the pain stops, or whether you see any abnormal signs, it’s still important your child see us for an accurate diagnosis. Their toothache maybe trying to tell you something’s wrong — and the earlier a problem is found and treated, the better the outcome.
If you would like more information on dental problems in young children, 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 Child’s Toothache.”
First introduced in the 1980s, dental implants are a popular and reliable tooth replacement option. Numerous studies show that after ten years 95% are still in place. Much of this success owes to the implant’s titanium post imbedded directly into the jaw, which then attracts bone growth. This additional growth securely anchors the implant in place for an unrivaled durability among other replacement options.
Still, a small percentage of implants fail — some in the first few months and others after a few years. Here are 3 reasons why, and how you can overcome them.
Poor bone quantity and quality. Implants need a certain amount of existing bone to succeed. Sometimes, though, there isn’t enough because prolonged absence of a tooth causes bone loss around the empty socket. Conditions like diabetes, osteoporosis or tobacco use can also compromise bone health. It’s often possible to increase bone volume with grafting, especially right after tooth extraction.
Teeth grinding habits. This occurs when you unconsciously grind or clench your teeth, usually during sleep. The habit can create forces far in excess of what’s normal when we bite or chew and can damage or even break the crown attached to an implant. Besides reducing stress (a major factor for teeth grinding), you can also alleviate the abnormal force generated by wearing a night guard.
Periodontal (gum) disease. Although your implants are impervious to disease or infection, supporting gums and bone aren’t. Plaque, a film of food and bacteria that builds up on tooth surfaces, can cause gum disease that weakens the supporting tissues (gums and bone) of the implant. This can give rise to a specific condition with implants known as peri-implantitis where the infected gum tissues and bone around it deteriorate, leading to the implant’s catastrophic loss. To avoid this, practice consistent daily hygiene, including around the implant. And see us regularly for checkups and cleanings, or as soon as possible if you see signs of gum problems.
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 “Dental Implants: A Tooth-Replacement Method that Rarely Fails.”
If your sleeping partner snores, it could be more than an annoyance: it could be a sign of sleep apnea. This occurs when air flow into the lungs becomes obstructed in the throat for a few seconds during sleep. The obstruction can take many forms, but a common one arises from the tongue relaxing against the back of the throat, producing snoring sounds as air attempts to pass through this restricted area.
Sleep apnea can cause severe problems: lower daily energy levels and mood from poor sleep; lower oxygen saturation that could affect brain function; and increased risk for cardiovascular disease. So, if you’re awakened by your partner’s snoring (or they’re complaining about yours!), it’s important to have it checked and treated.
This begins with a visit to us for a complete oral examination. Like many dentists, we’re well trained in the anatomy and structures of the mouth, as well as the causes and treatment of sleep apnea. We’ll examine your mouth, take into account any possible symptoms you’re experiencing and, if your suspicions are correct, refer you to a sleep physician to diagnose if you have sleep apnea.
Treatment will depend on its cause and severity. An oral appliance worn during sleep is the recommended first treatment for mild to moderate sleep apnea that involves the tongue as an obstruction. We develop a custom appliance that helps move your tongue away from the back of the throat, reducing both apnea and snoring sounds. For more advanced sleep apnea you could benefit from a Continuous Positive Airway Pressure (CPAP) machine. This device generates continuous air pressure through a mask worn while sleeping that helps keep the airway open.
Of course, there are other causes for obstruction, some of which may require surgical intervention to relieve the problem. Abnormally large tonsils, adenoids or excessive soft tissue can all restrict air flow. Surgically removing or altering these structures could help reduce airway restriction.
Whatever type or degree of sleep apnea you or your partner may have, there are solutions. The right treatment will not only improve overall health, it will help both of you get a better night’s sleep.
If you would like more information on sleep apnea and how to treat it, 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 “If You Snore, You Must Read More!”
You’re satisfied with your smile appearance except for one thing — your teeth aren’t as white and bright as you wish they could be. So, you’ve decided to do something about their dull yellow color.
You’re also thinking about buying a whitening product you can use yourself rather than a professional application. But you still want the answers to two questions: are home whitening kits safe? And, are they effective?
By and large the answer to the first question is yes — if you use it as directed. The whitening agents in FDA-approved products are in safe proportions to other ingredients and won’t cause any major health issues. That said, if you go beyond the instructed dosage you could damage your teeth, especially your enamel, and cause long-term problems with your dental care.
In addition, if you (or a family member) are still in your early teens, you may want to wait until you’re older. Although most permanent teeth have come in by puberty, their enamel still needs to mature. The chemicals in a whitening kit could be too strong for their under-developed enamel. It’s best to get our advice on whether your teeth are mature enough for whitening.
As to their effectiveness, home whitening kits should perform as their labeling indicates. But there are some differences in effects between a home kit and a professional application.
Although a home kit usually uses the same whitening agents (like carbamide peroxide), its strength is much lower than a professional treatment — about 10% of volume compared to around 30% in clinical solutions. This means it will take much longer to achieve the desired whitening effect that a professional application can in fewer sessions, and with less precision. In addition, home kits are only effective on surface staining of the enamel — discoloration within a tooth requires treatment by a dentist.
You can get satisfactory results from a home whitening kit. But before you make a purchase, consult with us first — we can advise you on what to look for in your purchase, as well as determine if your teeth can benefit from whitening at home.
If you would like more information on teeth whitening, 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 Whitening Safety Tips.”
While it’s common for most of us to get an occasional cold sore, you may suffer from regular breakouts. If so, you know firsthand how uncomfortable and embarrassing they can be and seeming to erupt at the most inopportune moments.
What you’re experiencing is the result of a virus — the Herpes Simplex virus (HSV) Type I to be exact. Don’t let the name disturb you — although similar it’s different from the sexually transmitted virus known as HSV Type II. As with any virus the body responds by making and distributing antibodies to stop its attack. That’s typically the end of it but for some people the virus appears to be able to hide in the nerve roots of the mouth and elude the effects of the antibodies.
The sores associated with the virus tend to break out when a person is under stress, experiences trauma to the lip or even from sun exposure. The breakout begins with a slight itching or burning around the mouth that typically advances to more severe itching, swelling, redness and blistering. Eventually the sores will scab over and heal as the outbreak winds down. The period from breakout to final healing (during which you’ll also be contagious to others) usually lasts seven to ten days.
Although normally not a danger to health, cold sore outbreaks can be painful and irritating. In the past, most patients simply had to let the outbreak run its course with topical ointments to ease discomfort.Â In the last two decades, however, new anti-viral medication has proven effective in preventing the outbreaks in the first place or at least lessening their duration.
If you have regular bouts of cold sores prescription drugs like acyclovir or valcyclovir taken orally can help suppress the occurrences altogether, and have few side effects. Topical agents can also be used as a supplement to the drugs to help ease itching and other pain symptoms.
It’s important, though, that you undergo a complete oral examination to rule out more serious conditions associated with mouth sores. If we find that your problem is recurring cold sores, these new treatments could help you escape the cycle of discomfort.
If you would like more information on the treatment of chronic cold sore outbreaks, 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 “Cold Sores.”