If you have tooth pain, we want to know about it. No, really—we want to know all about it. Is the pain sharp or dull? Is it emanating from one tooth or more generally? Is it constant, intermittent or only when you bite down?

Dentists ask questions like these because there are multiple causes for tooth pain with different treatment requirements. The more accurate the diagnosis, the quicker and more successful your treatment will be.

Here are 3 different examples of tooth pain, along with their possible causes and treatments.

Tooth sensitivity. If you feel a quick jolt of pain when you eat or drink something hot or cold, it may mean your gums have drawn back (receded) from your teeth to leave more sensitive areas exposed. Gum recession is most often caused by gum disease, which we can treat by removing dental plaque, the main cause for the infection. In mild cases the gums may recover after treatment, but more advanced recession may require grafting surgery.

Dull ache around upper teeth. This type of pain might actually be a sinus problem, not a dental one. The upper back teeth share some of the same nerves as the sinus cavity just above them. See your dentist first to rule out deep decay or a tooth grinding habit putting too much pressure on the teeth. If your dentist rules out an oral cause, you may need to see your family physician to check for a sinus infection.

Constant sharp pain. A throbbing pain seeming to come from one tooth may be a sign the tooth's central pulp layer has become decayed. The resulting infection is attacking the pulp's nerves, which is causing the excruciating pain. Advanced decay of this sort requires a root canal treatment to remove the diseased tissue and fill the empty pulp chamber and root canals to prevent further infection. See your dentist even if the pain stops—the infection may have only killed the nerves, but is still present and advancing.

Pain is the body's warning system—so heed the tooth pain alert and see your dentist as soon as possible. The sooner the problem is identified and treated, the better your chances of returning to full dental health.

If you would like more information on tooth pain and what it means, 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 Pain? Don't Wait!”

Surgical tooth extraction is a fairly routine procedure with few complications. But one rare complication called dry socket does affect a small number of patients. Dry socket, which derives its name from its appearance, can be quite painful. Fortunately, though, it doesn't pose a danger to oral health.

Normally after a surgical extraction, a blood clot forms in the empty socket. This is nature's way of protecting the underlying bone and nerves from various stimuli in the mouth as well as protecting the area. Sometimes, though, the clot fails to form or only forms partially (almost exclusively in lower wisdom teeth), exposing the sensitive tissues beneath the socket.

Patients begin to notice the painful effects from a dry socket about three or four days after surgery, which then can persist for one to three more days. Besides dull or throbbing pain, people may also experience a foul odor or taste in their mouth.

People who smoke, women taking oral contraceptives or those performing any activity that puts pressure on the surgical site are more likely to develop dry socket. Of the latter, one of the most common ways to develop dry socket is vigorous brushing of the site too soon after surgery, which can damage a forming blood clot.

Surgeons do take steps to reduce the likelihood of a dry socket by minimizing trauma to the site during surgery, avoiding bacterial contamination and suturing the area. You can also decrease your chances of developing a dry socket by avoiding the following for the first day or so after surgery:

• brushing the surgical area (if advised by your surgeon);
• rinsing too aggressively;
• drinking through a straw or consuming hot liquid;
• smoking.

If a dry socket does develop, see your dentist as soon as possible. Dentists can treat the site with a medicated dressing and relieve the pain substantially. The dressing will need to be changed every few days until the pain has decreased significantly, and then left in place to facilitate faster healing.

While dry sockets do heal and won't permanently damage the area, it can be quite uncomfortable while it lasts. Taking precautions can prevent it—and seeing a dentist promptly if it occurs can greatly reduce your discomfort.

If you would like more information on oral surgery, 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 “Dry Socket: A Painful but Not Dangerous Complication of Oral Surgery.”

Besides their life-likeness, implants are also prized for their high success rate. More than ninety-five percent of implants continue to function effectively after ten years.

Implants’ advanced technology explains some of their reliability and longevity—they’re as close to natural teeth as we’re now able to achieve. But their impressive success rate also owes to the detailed protocols that dentists follow to install them. One critical part of these protocols is ensuring a patient has enough bone in their jaw to support and precisely situate the implant for the best functional and aesthetic outcome.

Unfortunately, there are situations where a patient doesn’t have enough bone to achieve a satisfactory result. This often happens if there’s been months or years between losing the tooth and considering an implant. The reason why relates to the nature of bone as living tissue.

Like other cellular tissues in the body, bone has a life cycle: Older, worn-out cells die and are absorbed by the body, and new cells form to replace them. The growth cycle in the jaw receives stimulation from the forces generated when we chew, which travel up through the teeth to the bone.

However, this stimulation stops after tooth loss for the related area of bone, which can slow new bone growth. Over time, the volume and density of the bone around a missing tooth gradually decreases, enough eventually to make an implant impractical.

Insufficient bone volume, though, doesn’t necessarily mean an implant is out of the question. We may be able to address the problem by attempting to regenerate the bone through grafting. This is a procedure in which we insert graft material into the affected area of the jawbone. The graft then becomes a scaffold upon which bone cells can grow.  After several months, we may have enough regenerated bone to support an implant.

If there’s been too much bone loss, we may still need to consider another form of restoration. But if we can successfully build up the bone around your missing tooth, this premier restoration for replacing lost teeth could become a reality for you.

If you would like more information on dental implants, please contact us or schedule an appointment for a consultation.

The ongoing opioid addiction epidemic has brought together government, law enforcement and healthcare to find solutions. The focus among doctors and dentists has been on finding ways to reduce the number of opioid prescriptions.

Opioids (or narcotics) have been a prominent part of pain management in healthcare for decades. Drugs like morphine, oxycodone or fentanyl can relieve moderate to extreme pain and make recovery after illness or procedures much easier. Providers like doctors and dentists have relied heavily on them, writing nearly 260 million narcotic prescriptions a year as late as 2012.

But although effective when used properly, narcotics are also addictive. While the bulk of overall drug addiction stems from illegal narcotics like heroin, prescription drugs also account for much of the problem: In 2015, for example, 2 million Americans had an addiction that began with an opioid prescription.

The current crisis has led to horrific consequences as annual overdose deaths now surpass the peak year of highway accident deaths (just over 54,000 in 1972). This has led to a concerted effort by doctors and dentists to develop other approaches to pain management without narcotics.

One that’s gained recent momentum in dentistry involves the use of non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs like acetaminophen, ibuprofen or aspirin work by dilating blood vessels, which reduces painful inflammation. They’re available over the counter, although stronger doses require a prescription.

NSAIDs are effective for mild to moderate pain, but without the addictive properties of narcotics. There are some adverse health consequences if taken long-term, but limited use for pain or during post-procedure recovery is safe.

Many dentists are recommending NSAIDs for first-line pain management after most dental procedures. Narcotics may still be prescribed, but in a limited and controlled fashion. As part of this new approach, dentists typically combine ibuprofen and acetaminophen: Studies have shown the two work together better at reducing pain than either one individually.

Still, many aren’t eager to move away from the proven effectiveness of narcotics to primarily NSAIDs. But as these non-addictive drugs continue to prove their effectiveness, there’s hope the use of addictive opioids will continue to decrease.

If you would like more information on pain management practices in dental care, please contact us or schedule an appointment for a consultation.

As a parent, you’re all about helping your kids grow up healthy. But there are some obstacles that can make that difficult. One in particular is tooth decay, which could interfere with their dental development.

A bacterial infection, tooth decay destroys dental tissue—and untreated it could lead to tooth loss. This could severely derail a child’s normal development, even if it’s one of their primary (“baby”) teeth. That’s why preventing tooth decay or treating it promptly when it occurs should be one of your top priorities for your child’s dental health.

Here are 3 things you can do to minimize your child’s risk of tooth decay.

Start oral hygiene early. Your best defense against tooth decay is to clean your child’s teeth daily of dental plaque, a thin film of bacteria and food particles that’s the main driver for dental disease. The best way to do this is with brushing and flossing, so begin performing these tasks with your child as soon as their teeth begin to appear. Oral hygiene is also important before their teeth come in—simply wipe your infant’s gums after nursing with a clean damp cloth to reduce bacteria in the mouth.

Start dental visits early. By age 1, most children already have quite a few teeth, making it the recommended time to schedule their first dental visit. Not only will this and subsequent visits support your plaque removal efforts, they also give your dentist an opportunity to catch any emerging dental issues. Early visits can also help get your kids used to seeing the dentist, reducing the chances they’ll develop dental visit anxiety later in life.

Avoid “baby bottle decay.” Sugar is one of decay-causing bacteria’s favorite food sources, so restricting your child’s intake of this carbohydrate can lower their decay risk.  Besides limiting sugary snacks and sweets, be sure you do one more thing: eliminate sugar from the nighttime or naptime baby bottle. Parents often lay babies down to sleep with a bottle filled with sugary liquids like juice, milk or formula. Either avoid giving the bottle or make sure it only contains water.

If you would like more information on how to help your kids’ dental development stay on a healthy track, 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 “Top 10 Oral Health Tips for Children.”