Common Symptoms / Questions
Sensitivity can occur when enamel is worn away and the underlying layer, called dentin, is exposed, or if you recently had a deep filling placed. Dentin has tubules which act like pores that communicate to the nerves and blood vessels inside the tooth. The sensitivity you feel may be caused by the movement of fluids in and out of these pores, or changes in temperature. Sometimes your tooth can heal. The blood vessels inside the tooth can deposit dentin and block the tubules themselves. Desensitizing agents can sometimes be applied to exposed dentin closing these pores from the outside as well. Fluoride treatments can also help to add mineral and strengthen the dentin, which can help with the sensitivity caused by bleaching. Sensitivity can be more complex. A large deep filling may cause sensitivity, which may either heal on its own, or progress into an irreversible situation. In any instant, your sensitivity should be systematically tested by us to be sure. There are more severe types of sensitivity that can cause permanent injury to the nerves and blood vessels inside the tooth. If the nerve does not heal on its own, it can eventually die and become inflamed or infected, needing a root canal. This type of condition is usually consistent with a larger injury or cavity extending deep into the dentin.
A tooth may experience pain based on the degree and nature of the injury to the tooth. A chip in the enamel, a small cavity, an old filling, or a large cavity that extends into the nerve of the tooth may cause pain in many different forms. Often the offending tooth may refer pain to other areas, or to make matters worse, the pain can go away, just in time for your visit to us. For you, it may not always be easy to tell which tooth is causing the problem. A thorough exam, an x-ray, and a detailed system of tests will help us localize the offending tooth. The best possible treatment for that tooth is based on what we know about you, your overall health, and the objective data that we gather. In our view, if a minimally-invasive treatment can resolve your pain and work for the long term, it will be used first. If natural tooth structure can be preserved, it will be. It can be as simple as shaving down a tooth that is biting too high, applying a desensitizing agent, or placing a filling. There are times however, such as in cases of severe decay, injury, or loss of surrounding bone, that the tooth will need a larger filling, a crown, root canal or an extraction. In these cases, we insist on providing you with a comfortable and pain-free experience, and we will work until you are happy with the result. It is our view that the reason for any treatment decision should be apparent to you, and that you always have choices.
If you are experiencing bleeding gums when brushing or eating, you may have an infection. Left untreated, this infection can cause destruction to the surrounding bone and soft tissues; it may progress into periodontal disease. Untreated periodontal disease means that there is a constant source of bacteria and inflammation in the mouth, which can affect the entire body. Recent evidence has linked periodontal disease and its accompanying inflammatory process with coronary artery disease, stroke, complications with diabetes, and low birth weight. In diagnosing the pain in your gums, we feel it is important to gather very specific information about you, your overall health, your diet and your hygiene routine. The treatment that is right for you is very specific. It may involve adjustments in your medications or diet, or coaching you on how to maintain specific sites in your gums. When you become an active participant in your dental health, this helps to make your treatment as minimally invasive as possible. Surgical treatment of periodontal disease is an option that may need consideration, but only after the best efforts are made at a comprehensive, medical approach. Good tissue health can often be achieved without surgery. Your soft tissue is very much a part of your smile. Having healthy gums and a good soft tissue profile will also help achieve the best possible results for any crowns, bridges, or reconstructive work.
Many patients complain of pain in the jaw, pain on opening or closing, or pain when waking up in the morning. Like tooth pain, jaw pain can be unpredictable and have a number of different possible causes. It can be based upon an underlying medical or neurological condition, or a habit like clenching or grinding the teeth. Patients having excessively worn teeth or no teeth may experience jaw pain due to a collapsed bite, because the jaw routinely closes beyond its normal intended range. These patients may benefit from restorations or prostheses that open the bite to its original level. Jaw pain can even be referred pain from a decayed or impacted tooth. Treatments for jaw pain vary greatly, and the complexity of your treatment will depend on the severity of the underlying cause. It is our aim to gather all possible evidence and to isolate the underlying cause. If you have a decayed tooth, or a clenching or grinding habit, then treating the offending tooth, or providing you with a bite splint can often work. Jaw pain is complex. Before surgical options are considered, a comprehensive management approach is the first line of defense.
Today, many patients are interested in whitening their teeth. Whitening may be an option, but the underlying cause of the staining must be determined first. Many patients are surprised to learn just how much of an impact they can have on their teeth with simple modifications in their diet and hygiene routines. If you are a patient who smokes, drinks coffee, red wine, or soda, bleaching can do serious harm to your teeth, and its results will be short-lived. The first step is to establish a good home-care regimen with you. Once you understand the biology of your mouth, and how to promote a continuous neutral pH in your mouth, your teeth may get lighter before we even begin whitening. The key is in knowing this simple fact: Every time you take a sip of a sugary or acidic drink, your mouth becomes an acidic environment, which takes an hour to return to neutral pH on its own. If you limit the amount of offending foods/drinks between meals, and restrict them to mealtime, you’re promoting a better oral environment. Drinking tap water also helps. A gentle brushing after lunch; rinsing with water after drinking coffee or red wine… these small things can make a huge difference. Whitening then, will be more effective for you in the long term. For some people, whitening simply will not work. Intrinsic Staining refers to stains that may have been incorporated into your teeth during development. During childhood, excessive fluoride intake, tetracycline, and high fever can cause color changes in developing teeth that will be unaffected by bleaching. The stains are called intrinsic because they are part of the makeup of the teeth. Whitening will not work on teeth stained by metal fillings either. In these cases, bonding, porcelain veneers, or crowns may be necessary.