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Dental Problems... "Can You Handle the Tooth?!"

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Sensitive Teeth
Many people suffer from sensitive teeth - a condition in which hot and cold foods or liquids (or even puffs of cold air) can cause discomfort and pain.

Tooth sensitivity can be caused by a number of factors. The primary culprit is often an unnoticed cavity or abscessed tooth. However, over time and with natural age progression, changes in temperature, behaviors such as tooth grinding (bruxism) and overly aggressive brushing, can cause small, often microscopic cracks or fissures on the chewing surfaces of your teeth (or near the gum lines), which exposes the inner structures called dentin. The roots, which are not covered by hard enamel, contain thousands of tiny tubules leading to the tooth's nerve center (the pulp). These dentinal tubules (or channels) allow the stimuli - for example, the hot, cold, or sweet food - to reach the nerve in the tooth, which results in pain or feelings of sensitivity.

Hypersensitive teeth can cause people to change their eating habits, avoid social situations, or even avoid proper oral hygiene because the simple act of brushing or rinsing causes pain. Relief can sometimes be achieved by using desensitizing toothpastes, sealants, or special fillings.

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Abscessed Tooth

A tooth abscess is a collection of pus that forms due to a bacterial infection in the roots of teeth or in the gum tissue surrounding teeth. The main symptom of a tooth abscess is a severe, persistent, throbbing toothache. Initially, the tooth may be sensitive to heat and pressure with chewing or biting. Later, you may develop a fever, swelling in your face or cheek, and tender, swollen lymph nodes under your jaw or in your neck. If the abscess ruptures, you will have a sudden rush of foul-smelling and foul-tasting fluid in your mouth.

A tooth abscess will not go away without treatment. If the abscess ruptures, the pain may decrease significantly, but dental treatment is still needed. If the abscess doesn't drain, the infection can spread to other areas of the head and neck and even become life-threatening.

Treatment of a tooth abscess is directed at eliminating the infection, preserving the tooth and preventing complications. Treatment may include draining the abscess, prescribing antibiotics or warm saltwater rinses. Root canal therapies are the most common forms of treatment. Root canal treatment involves removing the infected tissue, cleansing and sealing the canal of the tooth and restoring the tooth with a crown, or cap.

If the tooth cannot be restored, surgical extraction of the infected tooth is a last resort option. The missing tooth may later be replaced with a fixed bridge or dental implant.

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Cavities

Cavities, commonly referred to as "caries" in the dental world, are caused by long-term destructive forces acting on tooth structures such as enamel and the tooth's inner dentin material.

These destructive forces include frequent exposure to foods rich in sugar and carbohydrates. Soda, candy, ice cream and even milk are the common culprits. Left inside your mouth from non-brushing and flossing, these materials break down quickly, allowing bacteria to do their dirty work in the form of a harmful, colorless sticky substance called plaque. The plaque works in concert with leftover food particles in your mouth to form harmful acids that destroy enamel and other tooth structures.

If cavities aren't treated early enough, they can lead to more serious problems requiring treatments such as root canal therapy.

But as decay gets worse, it may cause such symptoms as:

  • Toothache or tooth pain
  • Tooth sensitivity
  • Mild to sharp pain when eating or drinking something sweet, hot or cold
  • Pain that lasts even after you stop eating or drinking
  • Visible holes or pits in your teeth
  • Pain when you bite down
  • Pus around a tooth

Preventing Cavities

The best defense against cavities is good oral hygiene, including brushing with a fluoride toothpaste, flossing and rinsing. Your body's own saliva is also an excellent cavity fighter, because it contains special chemicals that rinse away many harmful materials. Chewing a good sugarless gum will stimulate saliva production between brushing.

Special sealants and varnishes can also be applied to stave off cavities from forming.

If you have any of the following symptoms, you may have a cavity:

  • Unusual sensitivity to hot and cold water or foods.
  • A localized pain in your tooth or near the gum line.
  • Teeth that change color.
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Wisdom Teeth

Wisdom teeth are the third and final set of molars that erupt in the back corners of the upper and lower normal adult mouth. These teeth usually appear in late teens or early twenties but may become impacted (fail to erupt) due to lack of room in the jaw or angle of entry. The most common type of impacted wisdom tooth is "mesial", meaning that the tooth is angled forward toward the front of your mouth.

When a tooth is impacted, it is often necessary that it has to be extracted. If the impacted tooth is not removed, a variety of problems can develop including nuisance pain, inflammation, swelling, or even severe pain. Impacted wisdom teeth that are partially or even fully erupted tend to be extremely difficult to clean and are susceptible to tooth decay, recurring infections, and even gum disease.

Every patient's situation is unique, and your dentist will take x-rays, normally a panoramic film, and discuss your particular needs with you. If your dentist recommends removal of your wisdom teeth, it is best to have them removed sooner than later. As a general rule, wisdom teeth are removed in the late teens or early twenties because there is a greater chance that the teeth's roots have not fully formed and the bone surrounding the teeth is less dense.

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Dry Mouth

Saliva is one of your body's natural defenses against plaque because it acts to rinse your mouth of cavity-causing bacteria and other harmful materials. Dry mouth (Xerostomia) is a relatively common condition that is caused by reduced saliva production. People with medical conditions, such as an eating disorder or diabetes, are often plagued by dry mouth. Eating foods such as garlic, tobacco use, and some kinds of medications, including treatments such as cancer therapy can diminish the body's production of saliva, leading to dry mouth. Other causes are related to aging (including rheumatoid arthritis), and immune system disorder such as Sjogren's (pronounced SHOW-grins) syndrome. In Sjogren's syndrome, your immune system attacks healthy tissue. The mucous membranes and moisture-secreting glands of your eyes and mouth are usually affected first, resulting in decreased production of tears and saliva. The disease can damage other tissues as well. Although you can develop Sjogren's syndrome at any age, most people are older than 40 at diagnosis. The condition is much more common in women. There's no cure, but treatments can relieve many symptoms.

Some of the less alarming results of dry mouth include bad breath. But dry mouth can lead to more serious problems, including burning tongue syndrome which is a painful condition caused by the lack of moisture on one's tongue. If dry mouth isn't readily apparent, you may experience other conditions that dry mouth can cause, including an overly-sensitive tongue, persistent thirst or even difficulty in speaking.

If there is not a medical condition causing dry mouth, the symptoms can be minimized by regularly sipping water, chewing gum and avoiding smoking. Of course, there is no substitute for regular checkups and good oral hygiene.

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Bad Breath

Bad breath is a common affliction with many people. When it progresses or becomes constantly noticeable, it develops into a condition known as chronic halitosis.

While people spend lots of money on products that treat the symptoms of bad breath, they often neglect to take steps to address the root causes of bad breath such as bacteria, and decaying food particles that remain in spaces between the teeth, on the gums and on the tongue. In many cases, good daily oral hygiene, including brushing, flossing and rinsing, can keep bad breath in check.

Other conditions, such as gum disease, can cause persistent bad breath. Under normal conditions, your saliva acts to cleanse your mouth of the particles that can decay and later cause bad breath. People with a condition known as dry mouth, in which saliva production is diminished, can sometimes suffer from bad breath. Of course, if you eat certain kinds of food (like garlic and onions), take certain kinds of medications, or smoke cigarettes or cigars, you may also experience symptoms of bad breath.

In some cases, persistent bad breath may be a sign that you have a more serious health issue, including a gastrointestinal, respiratory or sinus problem.

Over-the-counter mouthwashes and rinses temporarily freshen breath, but only mask the root cause. The American Dental Association acknowledges the effectiveness of some anti-microbial mouth rinses that are shown to reduce plaque and gingivitis. Good oral health habits including brushing and flossing daily as well as regular professional cleanings performed by our office can contribute to reducing and eliminating halitosis.

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Bruxism

Bruxism, a condition which affects both children and adults is the medical term for grinding, gnashing or clenching your teeth. Although bruxism is viewed as an annoying habit, it can literally transform your bite relationship and worse, severely damage your teeth and jaws over long periods of time.

Teeth grinding can cause abrasion to the chewing surfaces of your teeth. This abnormal wear and tear will prematurely age and loosen your teeth, and open them to problems such as hypersensitivity (from the small cracks that form, exposing your dentin). Bruxism can also lead to chronic jaw and facial pain, as well as headaches.

Bruxism may be mild and may not even require treatment. However, it can be frequent and severe enough to lead to jaw disorders, headaches, damaged teeth and other problems. Unfortunately, people with sleep bruxism usually aren't aware of the habit, so they aren't diagnosed with the condition until complications occur. That's why it's important to know the signs and symptoms of bruxism and to seek regular dental care.

The signs and symptoms of bruxism may include:

  • Teeth grinding or clenching, which may be loud enough to wake your sleep partner
  • Teeth that are worn down, flattened or chipped
  • Worn tooth enamel, exposing the inside of your tooth
  • Increased tooth sensitivity
  • Jaw pain or tightness in your jaw muscles
  • Earache - because of severe jaw muscle contractions, not a problem with your ear
  • Headache
  • Chronic facial pain
  • Chewed tissue on the inside of your cheek
  • During regular dental exams, your dentist likely will check for physical signs of bruxism, such as unusual wear and tear on your teeth, broken dental restorations and tooth sensitivity. Continued breakdown of dental restorations, loss of crowns and fracture of teeth are frequent problems associated with the tooth grinding and clenching associated with bruxism. If you have any of these signs, your dentist will look for changes in your teeth and mouth over the next several visits to see if the process is progressive and to determine whether you need treatment. You may also be asked to return for additional exams.
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Jaw Disorders

One of the most frequent jaw disorders is related to a problem with the temporomandibular joint (TMJ), the joint that connects your lower jaw to your skull, and allows your upper and lower jaw to open and close.

It is estimated that 75% of the U.S. population has experienced one or more symptoms of temporomandibular joint disorders (TMD). In most cases, pain and discomfort associated with TMJ disorders can be alleviated with self-managed care or nonsurgical treatments, but more severe cases may need to be treated with dental or surgical interventions.

The cause of some TMJ disorders can be traced to trauma from a severe blow to the jaw, degeneration of the joint, osteoarthritis, rheumatoid arthritis or other forms of inflammation. However, the causes of many cases of TMJ disorders are not always clear. Some experts believe that responses to stress or anxiety may be a primary or contributing causal factor.

If you frequently clench your jaw when you're stressed, irritated or concentrating, the muscles of the TMJ are kept in a contracted position - not unlike the discomfort you would probably feel if you flexed your biceps all day. Similarly, you may respond to tension or anxiety by grinding your teeth (bruxism). You may even clench your jaw or grind your teeth in your sleep without realizing it.

Other habits that overwork the jaw muscles, such as chewing on a pen or chewing gum, may exacerbate the pain of TMJ disorders. Poor posture of the head, neck and shoulders - such as pushing your head forward or slouching while working at a computer - may put strain on the muscular and skeletal systems that are closely related to the jaw muscles and joints.

Signs and symptoms of TMJ disorders may include:

  • Pain or tenderness of your jaw
  • Aching pain in and around your ear
  • Difficulty chewing or discomfort while chewing
  • Aching facial pain
  • A clicking sound or grating sensation when opening your mouth or chewing
  • Locking of the joint, making it difficult to open or close your mouth
  • Headache
  • Uncomfortable bite
  • An uneven bite, because one or more teeth are making premature contact

You may feel pain or tenderness, even when you aren't moving your jaw. But in most cases, the pain or tenderness worsens when you move your jaw.

If you have persistent pain or tenderness in your TMJ, if you have facial pain and experience clicking or grating when you chew or move your jaw, or if you can't open or close your jaw completely, seek medical attention. Your dentist or a TMJ specialist can discuss possible causes and treatments of TMJ disorders with you. Some treatments for TMD include muscle relaxants, aspirin, biofeedback, or wearing a small plastic appliance in the mouth during sleep.

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