Each year doctors treat about 150,000 new cases of severe facial pain. If you're one of those people, you don't have to suffer—there are ways to gain relief from these painful episodes.
Those recurring episodes are known as trigeminal neuralgia (TN). As the name implies, the source of the pain are the trigeminal nerves, which originate in the brain stem and extend on either side of the face. Each is divided into three branches (hence the "tri" in trigeminal) that serve the upper, middle and lower parts of the face and jaw.
TN can involve one or more of these branches, resulting in mild to severe pain that can last for several seconds. Jaw movements like chewing or speaking can trigger an episode, as well as a light touch to the face.
There are various proposed causes for TN, including links with inflammatory disorders like multiple sclerosis, which damages the insulating sheathing around nerve cells. The most common cause, though, appears to be a blood vessel pressing against the nerve. The compression causes hypersensitivity in that area of the nerve so that it transmits pain at the slightest sensation.
Other conditions like jaw joint pain disorders (TMD) or a dental abscess can cause similar pain symptoms, so it's important to get an accurate diagnosis. If your doctor does identify your condition as TN, you may then need a comprehensive approach to treatment involving a team of care providers, including your dentist.
For the most part, TN can be managed, beginning with the most conservative approach to gain relief, often with medications to block the nerve's pain signals to the brain or decrease abnormal nerve firings. If that proves insufficient, though, more intensive treatments are available.
One possible treatment for an impinging blood vessel is a microsurgical procedure to expose the affected nerve and relocate the vessel. While this can be effective, the surgery does carry some risk of facial numbness or decreased hearing. If the risks are too high for conventional surgery, an alternative procedure uses a precise beam of high-dose radiation to relieve the pressure from the vessel.
The most important thing to know about TN, though, is that it is possible to control it and relieve future pain episodes. If you're experiencing these symptoms, see your dentist or doctor for an exam and accurate diagnosis.
If you would like more information on trigeminal neuralgia, 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 “Trigeminal Neuralgia: A Nerve Disorder that Causes Facial Pain.”
While wearing braces is the path to a healthier and more attractive smile, it can be a difficult journey. One of your biggest challenges will be keeping your teeth clean to avoid a higher risk of tooth decay.
Tooth decay starts with dental plaque, a thin film of bacteria and food particles that accumulates on teeth. Daily brushing and flossing clear this accumulation. But the hardware of braces makes it difficult to access all tooth surfaces, and can even become a haven for plaque.
One sign in particular of tooth decay while wearing braces is the appearance of chalk-like spots on the teeth known as white spot lesions (WSLs). WSLs occur because the minerals in the enamel beneath them have begun to break down in response to decay. The spots can eventually cause both structural and cosmetic problems for a tooth.
The best approach to WSLs is to prevent them from developing in the first place. You'll need to be extra vigilant with daily oral hygiene while wearing braces to reduce plaque buildup. To help with the increased difficulty you might consider using a special toothbrush designed to maneuver more closely around orthodontic hardware. You may also find using a water flosser to be a lot easier than flossing thread.
Preventing tooth decay and WSLs also includes what you eat or drink to reduce the effects of enamel de-mineralization. The bacteria that cause decay thrive on sugar, so limit your intake of sweetened foods and beverages. And to avoid excessive demineralization cut back on acidic foods as well.
If despite your best preventive efforts WSLs still form, we can take steps to minimize any damage. For one, we can give your enamel a boost with fluoride applications or other remineralization substances. We can also inject a tooth-colored resin beneath the surface of a WSL that will make it less noticeable.
With any of these and other treatments, though, the sooner we can treat the WSL the better the outcome. Practicing good hygiene and dietary habits, as well as keeping an eye out for any WSL formations, will do the most to protect your new and improved smile.
If you would like more information on preventing dental disease while wearing braces, 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 “White Spots on Teeth During Orthodontic Treatment.”
The long-running hit show Dancing with the Stars has had its share of memorable moments, including a wedding proposal, a wardrobe malfunction, and lots of sharp dance moves. But just recently, one DWTS contestant had the bad luck of taking an elbow to the mouth on two separate occasions—one of which resulted in some serious dental damage.
Nationally syndicated radio personality Bobby Bones received the accidental blows while practicing with his partner, professional dancer Sharna Burgess. “I got hit really hard,” he said. “There was blood and a tooth. [My partner] was doing what she was supposed to do, and my face was not doing what it was supposed to do.”
Accidents like this can happen at any time—especially when people take part in activities where there’s a risk of dental trauma. Fortunately, dentists have many ways to treat oral injuries and restore damaged teeth. How do we do it?
It all depends on how much of the tooth is missing, whether the damage extends to the soft tissue in the tooth’s pulp, and whether the tooth’s roots are intact. If the roots are broken or seriously damaged, the tooth may need to be extracted (removed). It can then generally be replaced with a dental bridge or a state-of-the-art dental implant.
If the roots are healthy but the pulp is exposed, the tooth may become infected—a painful and potentially serious condition. A root canal is needed. In this procedure, the infected pulp tissue is removed and the “canals” (hollow spaces deep inside the tooth) are disinfected and sealed up. The tooth is then restored: A crown (cap) is generally used to replace the visible part above the gum line. A timely root canal procedure can often save a tooth that would otherwise be lost.
For moderate cracks and chips, dental veneers may be an option. Veneers are wafer-thin shells made of translucent material that go over the front surfaces of teeth. Custom-made from a model of your smile, veneers are securely cemented on to give you a restoration that looks natural and lasts for a long time.
It’s often possible to fix minor chips with dental bonding—and this type of restoration can frequently be done in just one office visit. In this procedure, layers of tooth-colored resin are applied to fill in the parts of the tooth that are missing, and then hardened by a special light. While it may not be as long-lasting as some other restoration methods, bonding is a relatively simple and inexpensive technique that can produce good results.
If you would like more information about emergency dental treatment, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor articles “The Field-Side Guide to Dental Injuries” and “Knocked Out Tooth.”
Occurrences of obesity and Type 2 diabetes have soared in the last few decades. While there are a number of influencing factors, health officials place most of the blame on one of our favorite foods: sugar. Only a generation ago we were consuming an annual average of 4 pounds per person. Now, it's nearly 90 pounds.
We've long known that sugar, a favorite food not only for humans but also oral bacteria, contributes to dental disease. But we now have even more to concern us—the effect of increased sugar consumption on health in general.
It's time we took steps to rein in our favorite carbohydrate. Easier said than done, of course—not only is it hard to resist, it's also hard to avoid. With its steady addition over the years to more and more processed foods, nearly 77% of the products on grocery store shelves contain some form of sugar.
Here's what you can do, though, to reduce sugar in your diet and take better care of your dental and general health.
Be alert to added sugar in processed foods. To make wiser food choices, become familiar with the U.S.-mandated ingredient listing on food product packaging—it tells if any sugar has been added and how much. You should also become acquainted with sugar's many names like "sucrose" or "high fructose corn syrup," and marketing claims like "low fat" that may mean the producer has added sugar to improve taste.
Avoid sodas and other prepared beverages. Some of the highest sources for added sugar are sodas, sports drinks, teas or juice. You may be surprised to learn you could consume your recommended daily amount of sugar in one can of soda. Substitute sugary beverages with unsweetened drinks or water.
Exercise your body—and your voice. Physical activity, even the slightest amount, helps your body metabolize the sugar you consume. And speaking of activity, exercise your right to have your voice heard by your elected officials in support of policy changes toward less sugar additives in food products.
Becoming an informed buyer, disciplined consumer and proactive citizen are the most important ingredients for stopping this destructive health epidemic. Your teeth—and the rest of your body—will thank you.
If you would like more information on the effects of sugar on dental and general health, 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 Bitter Truth About Sugar.”
Your teeth are sound and healthy—but appearance-wise, they're nothing to write home about. It's nothing major: a chip, some heavy staining or perhaps a slight gap between the front teeth. But whatever the blemish, it bothers you every time you look in the mirror.
There's an affordable way to improve your smile without a lot of extensive treatment: porcelain veneers. These thin layers of dental porcelain are bonded to the teeth's exterior to mask the blemishes beneath. All you and others can see, though, are beautiful teeth blending seamlessly with the rest of your natural teeth.
Changing your smile with veneers begins with a consultation with your cosmetic dentist. During your visit you'll discuss what you would like to improve and how you would like your smile to appear afterward. It's helpful to take along magazine photos or other images of how you'd like your teeth to look.
After making impressions and getting other necessary measurements, your dentist may then be able to show you what your new veneers will look like. One way is through computer software that superimposes your proposed new look onto a photograph of your face. Your dentist may also be able to create test veneers with acrylic or other dental materials and apply them to your teeth. These aren't your permanent veneers, but they can still give you a realistic view of your future smile.
Once your measurements are on the way to the dental lab to custom create your veneers, your dentist must prepare your teeth for bonding. Although veneers are quite thin, they may still appear bulky when bonded to the teeth. To create a more natural look, you'll probably need some of the enamel layer of your teeth removed to accommodate the extra width. Even though this is a small amount, it will permanently alter your teeth and require some form of restoration from then on.
After your veneers arrive, the dentist will attach them with a translucent cement that will bond them seamlessly to the natural teeth. You and others won't be able to see where the veneer ends and the natural tooth begins. What you will see, though, is a new look for your teeth and a more attractive smile.
If you would like more information on porcelain veneers, 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 “Porcelain Veneers: Strength & Beauty as Never Before.”
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