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YourToothacheMightSignalaProblemOtherThaninYourMouth

You expect a decayed tooth, a fracture or a gum infection to be the cause for that toothache causing you grief. Sometimes, though, the answer may be “none of the above”—there's nothing wrong going on in your mouth to cause the pain.

You pain is real—but its source is elsewhere in the body, a situation known as referred pain. It's important to find out the pain's true source to determine what kind of treatment you'll need to alleviate it.

Here are some of the likely candidates for a “toothache” that's not a toothache.

Facial nerves. Tooth pain may be associated with trigeminal neuralgia, a misfiring disorder of the trigeminal nerves that course through either side of the face. The nerve is divided into three branches, two of which are located in the upper face and one in the lower jaw. Because they're interconnected, a problem with one of the branches in other parts of the face could be felt in the branch around the jaw.

Jaw joints. Temporomandibular Joint Disorders (TMD) can cause pain in the pair of joints that connect the lower jaw to the skull. The joints can become inflamed due to stress or trauma and the associated muscles begin spasming, causing severe pain. Because of their proximity to the teeth, the pain from the joints can radiate into the dental area and mimic a toothache.

Ear or sinus infections. Both the ears and the maxillary sinus are subject to infections that can cause severe pain and pressure. With the close proximity of both the ears and the sinus to the upper jaw, it's quite possible for pain originating in these structures to be felt within the mouth.

These are only a few of the possibilities that also include migraines, shingles, fibromyalgia and even vitamin deficiencies. As such, your dentist or physician may need to do a little detective work to locate the true cause. But the effort to locate where your mouth pain is actually coming from will help ensure you get the right treatment to give you lasting relief.

If you would like more information on referred tooth pain, 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 “Referred Pain: When a Toothache Is Not Really a Toothache.”

HaveFunThisSummerButPlayitSafeforYourDentalHealthsSake

As summer reaches its apex here in the western hemisphere, warmer weather beckons many of us out of doors. And there's plenty of fun to be had, from hiking and camping to frolicking in the pool, so long as you're playing it safe—and that includes with your family's dental health.

As physical activity increases during the summer months, so does the potential for accidents. And our mouths—especially the teeth, gums and jaws—aren't immune: In the blink of an eye an accident could cause a serious oral injury that can reverberate for weeks, months or even years. Not only that, but dental diseases like tooth decay or gum disease don't take the summer off.

So have fun this summer, but take precautions with your family's dental health. Here are a few top things that deserve your focus.

Sports-related injuries. Summer often means outdoor sports like basketball and baseball. Even if you are shooting hoops alone or honing batting and catching skills with family members, accidents can happen, possibly resulting in an injury to the mouth. To guard against this, be sure the athletes in your family wear appropriate protective gear like helmets or mouthguards.

Slips and falls. Moving around outdoors, especially in unfamiliar territory, increases the risk for falls that could injure the mouth. A pool area can be especially hazardous: Hard surfaces that are slippery when wet, for example, are a tooth injury waiting to happen. So, try to eliminate structural hazards around pools or other high-risk areas as much as possible, and insist that everyone adhere to safety rules like “No running.”

Oral hygiene. Although not in the category of an accidental blow or fall, dental disease is still a year-round risk: Your family may be taking a break from routine, but disease-causing oral bacteria don't. So, encourage your family even in the more laid-back summer months to continue to brush and floss every day to minimize the development of tooth decay or gum disease.

Sugary snacks. Summer may also occasion a break from what your family normally eats. As a result, you may be munching more on foods with added sugar. Remember, though, oral bacteria love this particular carbohydrate as much as your family does. More sugar in the mouth means more bacteria and a higher risk of tooth decay. So, choose items like nuts or fresh fruit as much as possible in lieu of sugary treats.

Summer is a great time for relaxing in the open air and building fond family memories. Just be sure to exercise these preventive measures to keep oral accidents or dental disease from ruining the fun.

If you would like more information about dental prevention measures, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”

3ThingsThatCouldHelpYouAvoidAnotherRoundWithGumDisease

While periodontal (gum) disease could ruin your dental health, it doesn’t have to. Dentists and periodontists (specialists in gums and other supporting tooth structures) have effective methods for stopping it, especially if the infection is diagnosed and treated in its earliest stages. With effective treatment, those swollen, reddened and bleeding gums can return to a healthy shade of pink.

But even if we stop the infection, you’re not out of danger. If you’ve had at least one bout with gum disease, you’re at higher risk for another infection. We will need to maintain ongoing vigilance to prevent another infection.

If you’ve recently undergone treatment for gum disease, here are 3 things you should do to keep your now healthy gums continually healthy.

Practice daily oral hygiene. Gum disease arises most often from dental plaque, a thin biofilm of disease-causing bacteria that builds up on tooth surfaces. It’s important for everyone to remove this buildup with daily brushing and flossing, but it’s even more so if you’ve already experienced gum disease. Practicing effective oral hygiene every day will reduce the presence of bacteria that could ignite a new infection.

See the dentist more frequently. The general rule for routine dental cleanings and checkups is twice a year. But you may need more frequent visits, post-gum disease. Depending on the severity of your disease, we may recommend you make return visits at two- to three-month intervals of time. These visits may also include heightened screenings to ensure another infection hasn’t taken hold, as well as procedures to make it easier to clean certain tooth areas prone to plaque buildup.

Manage other health conditions. Gum disease’s severity is often caused by the inflammatory response your body initiates to fight the infection, which then becomes chronic. This is similar to other conditions like diabetes, heart disease or rheumatoid arthritis: There’s evidence inflammation elsewhere in the body could worsen a gum infection, and vice-versa. Managing other health conditions through medical care, medication and lifestyle changes could minimize the occurrence and severity of a future gum infection.

If you would like more information on remaining infection-free after gum disease, 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 “Periodontal Cleanings.”

WhatYouCanDoAboutBadBreathUnlessYoureaFamousActressPrankingYourCo-Star

Hollywood superstar Jennifer Lawrence is a highly paid actress, Oscar winner, successful producer and…merry prankster. She's the latter, at least with co-star Liam Hemsworth: It seems Lawrence deliberately ate tuna fish, garlic or other malodorous foods right before their kissing scenes while filming The Hunger Games.

It was all in good fun, of course—and her punked co-star seemed to take it in good humor. In most situations, though, our mouth breath isn't something we take lightly. It can definitely be an unpleasant experience being on the receiving end of halitosis (bad breath). And when we're worried about our own breath, it can cause us to be timid and self-conscious around others.

So, here's what you can do if you're concerned about bad breath (unless you're trying to prank your co-star!).

Brush and floss daily. Bad breath often stems from leftover food particles that form a film on teeth called dental plaque. Add in bacteria, which thrive in plaque, and you have the makings for smelly breath. Thorough brushing and flossing can clear away plaque and the potential breath smell. You should also clean your dentures daily if you wear them to avoid similar breath issues.

Scrape your tongue. Some people can build up a bacterial coating on the back surface of the tongue. This coating may then emit volatile sulfur compounds (VSCs) that give breath that distinct rotten egg smell. You can remove this coating by brushing the tongue surface with your toothbrush or using a tongue scraper (we can show you how).

See your dentist. Some cases of chronic bad breath could be related to oral problems like tooth decay, gum disease or broken dental work. Treating these could help curb your bad breath, as can removing the third molars (wisdom teeth) that are prone to trapped food debris. It's also possible for bad breath to be a symptom of a systemic condition like diabetes that may require medical treatment.

Quit smoking. Tobacco can leave your breath smelly all on its own. But a smoking habit could also dry your mouth, creating the optimum conditions for bacteria to multiply. Besides increasing your disease risk, this can also contribute to chronic bad breath. Better breath is just one of the many benefits of quitting the habit.

We didn't mention mouthrinses, mints or other popular ways to freshen breath. While these can help out in a pinch, they may cover up the real causes of halitosis. Following the above suggestions, especially dental visits to uncover and treat dental problems, could solve your breath problem for good.

If you would like more information about ways to treat bad breath, please contact us or schedule an appointment. To learn more, read the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”

HereIsHowWeMayBeAbletoBringanImpactedToothWhereItShouldBe

If all goes normally, we have most of our permanent teeth as we enter puberty. Except, though, when it doesn't—sometimes incoming permanent teeth don't fully erupt, often because there's not enough room for them on the jaw. This can leave all or part of a tooth still up inside the gum and bones.

This condition is known as impaction, and it can cause problems with a person's bite and their smile. This is especially true of the upper canines, those pointed teeth located just under the eyes. Without them present, a person's smile can look oddly different. Moreover, it can worsen their bite and increase the risk of trauma and disease for nearby teeth.

Fortunately, there may be a way to coax impacted canines into erupting into their proper position on the jaw. It will involve, though, some minor surgery and orthodontic intervention to accomplish that feat.

First, though, a patient with missing canines should undergo a thorough orthodontic evaluation. This exam will reveal not only what may be going on with the missing teeth, but how the whole bite has been affected. Knowing the big picture will help direct the next treatment steps.

After pinpointing the impacted teeth's exact position (usually through x-rays or cone beam CT scanning), we then decide whether it's feasible to attempt to expose the teeth. Sometimes, a tooth's position is so out of place that it may be best to remove it and consider a dental implant or other restorative measures.

If it is in a workable position, then the impacted teeth would be exposed surgically (usually by an oral surgeon or periodontist). The surgeon would then bond a small bracket to the exposed tooth and then attach a small chain.

After suturing the incised gum tissues back in place, the chain extending outward from the gums would then be looped over orthodontic hardware attached to other teeth. This will place downward pressure on the upper canine tooth, and over several months prod it to fully erupt.

This may sound like an elaborate procedure, but it's fairly routine and predictable. As a result, a patient can finally get the full benefit of all their teeth, enhance their dental health and transform their smile.

If you would like more information on dealing with impacted teeth, 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 “Exposing Impacted Canines.”





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