Posts for: July, 2013
You experience a painful toothache that lasts for a few days, but eventually the pain subsides. Since there's no longer any pain, there's no longer anything wrong with the tooth, right?
Maybe not — the toothache may be the result of a decay-induced infection that has developed deep in the pulp of the tooth. The infection inflames both the pulp tissue and the nerves bundled in it (a condition known as pulpitis). Because it occurs in an enclosed space, the pain is even more severe.
Now it's possible for the inflammation to subside and the nerves to heal, which would explain the pain subsiding. But there is another, more likely scenario: the infected pulp tissue can no longer fight the infection and dies. The affected nerves die also, which is why you no longer feel any pain — the dead nerves are no longer transmitting a signal to the brain. The infection, however, is very much alive and continues to advance deeper into the surrounding tissues where it may eventually develop into a painful abscess.
So, how can we determine which of these two scenarios you are actually experiencing? A visit to our office for testing is the surest way to find out. The most common test involves temperature sensation, usually with the application of ice to the affected tooth. If there's no sensation, then that's evidence the nerves in the tooth have died.
If that's the case, it's important then to take steps to stop the infection's advance before it does even more damage. The most likely treatment is a root canal, a procedure that accesses the pulp from the top of the tooth, removes the dead tissue, and then cleans and prepares the root canals for filling. This procedure can usually be performed in our office, but more involved cases may require an endodontist, a specialist in root canals.
In any case, if you experience a severe toothache, please have it examined. And remember — the absence of pain after a toothache doesn't necessarily mean the problem is gone.
If you would like more information on the diagnosis and treatment of an acute toothache, 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 Severe Toothache.”
Being “in the pink” is a good thing; it means you're healthy. Being “in the red” is not so good; it means your health is questionable (financially, anyway). Though they weren't coined for dentistry per se, these colorful expressions are helpful reminders when it comes to taking care of your gums: Pink is their natural, healthy color; that's what you want to see every time you look in the mirror. Red is generally a warning that something's amiss.
If your gums, or “gingiva,” appear slightly swollen and reddened at the margins and/or they bleed when lightly prodded by brushing or flossing, it's likely that you have gingivitis. This is an immune response to the buildup of bacterial plaque (biofilm) at your gum line. It is also an early red flag for periodontal disease (peri – around, odont – tooth), a degenerative process that affects not only the gums, but the periodontal ligament that attaches each tooth in its bony socket, and the underlying supporting bone.
Attentive home dental hygiene practices prevent most plaque buildup from occurring. Brushing correctly at the gum line is a good start. But even a deftly handled brush can't reach everywhere, so it's important to use dental floss or specially designed mini-brushes to get in between teeth and other hard-to-reach areas. Our office can instruct you on optimal home care techniques. We also encourage you to visit at regular intervals for professional cleanings so you are assured of addressing anything home care might miss.
In the absence of good oral hygiene, dental plaque can build and become increasingly difficult to remove as it calcifies, becoming tartar. It becomes a breeding ground for disease-causing microbes that normally wouldn't have the chance to gain a foothold. When caught early, gingivitis can be treated before any harm is done. Sometimes a thorough professional cleaning is sufficient. If the problem is ignored, however, the disease will most certainly progress to destruction of the surrounding, supporting tissues — the periodontal ligament and the underlying bone. If this happens, tooth loss could eventually result.
That said, there can be other causes for bleeding gums. These include:
- Brushing too rigorously or using a toothbrush with bristles that are too firm
- Side effect of a medication
- In women, elevated hormone levels (e.g., birth control pills or pregnancy)
- A systemic (bodily) disease
Whatever the reason, red is not normal when it comes to your gums. The sooner you discover the underlying reason(s) for inflammation or bleeding and take appropriate action, you and your smile will be back in the pink and you'll have no reason to be blue!
If you would like more information about preventing or treating bleeding gums, 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 “Bleeding Gums.”
It is sometimes hard to believe all of the features and characteristics that we inherit from our parents. Whether you're tall, short, blue-eyed or blonde, you can usually attribute some of these features to your mother and father. Of course, the downside of genetics is that diseases and disorders are also linked to genes.
Well, you can add gum tissue to that list as well! Genetics actually determines whether you have what we call “thin” or “thick” gum tissue. How does this work? Well, the type of gum tissue you have relies heavily on the shape of your tooth, which indeed is genetically-coded. If you have a triangular tooth shape, you'll likely have thin gums. If you have a squarer tooth shape, you'll usually have thick gums.
So, what can you expect from each tissue type?
If you have a thin gum tissue type, you are more likely to have gum recession. Watch out for the following signs of gum recession:
- Sensitivity to hot or cold, even without the presence of dental decay
- If you have crowns on your teeth, you may see a dark gray line at the gum line from the metal casting beneath the crown
- Small dark triangular spaces between teeth
On the other hand, if you have a thicker tissue type, your gums are more vulnerable to dental disease through a condition called “pocketing.” This happens when bacterial plaque causes your tissue to become inflamed, lose its attachment to the teeth and develop a pocket. Pocketing can result in bone loss, and, in worst-case scenarios, tooth loss.
It's important to note that while we use these terms to categorize different tissue types for treatment decisions, your tissue may also fall somewhere in between the two varieties.
So, how can you prevent gum disease? Daily oral hygiene is the best way to ensure proper care of your gums, no matter what type you have. Be sure to brush twice daily (use a soft toothbrush) and floss regularly at night. Floss gently until you hear a squeak, but watch out for your gum line. And of course, continue to visit us two times a year, so that we can assess whether you are in danger of developing gum disease.
If you would like more information about genetics and gum disease, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Genetics and Gum Tissue Types.”