Physical pain is unpleasant—but not knowing why you're hurting makes it worse. Thousands of people encounter such as experience when parts of their face suddenly and mysteriously erupt in pain.
Often, though, the mystery can be quickly solved—more than likely, it's a nerve disorder known as trigeminal neuralgia (TN). Typically seen in people over 50 (and in more women than men), TN is a chronic condition that produces brief episodes of acute, spasmodic pain.
The source of this pain is the trigeminal nerve, which courses down each side of the face. Each nerve consists of three distinct branches that serve the upper, middle and lower areas of the face and jaw.
Physicians usually find that a blood vessel has come in contact with the nerve at some point, and the resulting pressure has damaged the nerve's outer insulative layer (myelin sheath). This causes the nerve to become hypersensitive at the point of contact, overreacting in a sense to the slightest touch (even a wisp of wind) on the face and jaw.
TN isn't the only source of facial pain. It can also accompany other conditions like TMD, which is why it's important to undergo a diagnostic examination. If you are diagnosed with TN, there are a number of ways to manage it. The most conservative approach (and the one usually tried first) is the use of medications to block pain signals from the nerve to the brain or to lessen abnormal nerve firing.
If medication proves ineffective or there are other factors related to age and health, you may be a candidate for a surgical solution. In one such procedure, a surgeon inserts a thin needle into the affected nerve and selectively damages some of its fibers to prevent the transmission of pain signals. Another procedure relocates the impinging blood vessel, which then allows the nerve to heal.
These surgical methods are effective but they can cause side-effects in rare cases like numbness or hearing impairment. It's best then to discuss with your doctor which approach would be best for you and your life situation. Ultimately, though, there are ways to relieve you of this painful condition.
If you would like more information on treating facial 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 “Trigeminal Neuralgia.”
Best known for her roles in E.T. and Ever After, and more recently as a suburban mom/zombie on Netflix's Santa Clarita Diet, Drew Barrymore is now bringing her trademark quirky optimism to a new talk show, The Drew Barrymore Show on CBS. Her characteristic self-deprecating humor was also on display recently on Instagram, as she showed viewers how she keeps her teeth clean and looking great.
In typical Drew fashion, she invited viewers into her bathroom to witness her morning brushing ritual (complete with slurps and sloshes). She also let everyone in on a little insider Drew 411: She has extremely sensitive teeth, so although she would love to sport a Hollywood smile, this condition makes teeth whitening difficult.
Barrymore's sensitivity problem isn't unique. For some, bleaching agents can irritate the gums and tooth roots. It's usually a mild reaction that subsides in a day or two. But take heart if you count yourself among the tooth-sensitive: Professional whitening in the dental office may provide the solution you are looking for.
In the dental office, we take your specific needs into account when we treat you. We have more control over our bleaching solutions than those you may find in the store, allowing us to adjust the strength to match your dental needs and your smile expectations and we can monitor you during treatment to keep your teeth safe. Furthermore, professional whitening lasts longer, so you won't have to repeat it as often.
After treatment, you can minimize discomfort from sensitive teeth by avoiding hot or cold foods and beverages. You may also find it helpful to use a toothpaste or other hygiene product designed to reduce tooth sensitivity.
The best thing you can do is to schedule an appointment with us to fully explore your problems with sensitivity and how we may help. First and foremost, you should undergo an exam to ensure any sensitivity you're experiencing isn't related to a more serious issue like tooth decay or gum recession.
Having a bright smile isn't just advantageous to celebrities like Drew Barrymore—it can make a difference in your personal and professional relationships, as well as your own self-confidence. We can help you achieve that brighter smile while helping you avoid sensitivity afterward.
If you would like more information about teeth whitening, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Important Teeth Whitening Questions Answered.”
The worst outcome of periodontal (gum) disease is tooth loss—but it isn't the only form of misery you might suffer. One of the more troublesome results associated with gum disease is gum recession.
Normal gum tissue covers teeth from just above the visible crown to the roots, providing protection against bacteria and oral acid similar to the enamel on the crown. But advanced gum disease can weaken these tissues, causing them to pull away or recede from the teeth.
Not only can this diminish your smile appearance, but the exposed areas are more susceptible to further disease and painful sensitivity. And it certainly can accelerate tooth loss.
But there are some things we can do to reduce the harm caused by gum recession. If we're able to diagnose and treat a gum infection early while the gums have only mildly receded, the tissues could stabilize and not get worse.
The chances for natural regrowth are unlikely, especially the more extensive the recession. In such cases, the gums may need some assistance via plastic periodontal surgery. Surgeons reconstruct gum tissues by grafting like tissues to the area of recession. These grafts serve as a scaffold for new tissues to gradually grow upon.
There are two general types of grafting procedures. One is called free gingival grafting. The surgeon completely removes a thin layer of skin from elsewhere in the mouth (such as the palate), then shapes and attaches it to the recession site. Both the donor and recession sites heal at approximately the same rate, usually within 14-21 days. This procedure replaces missing gum tissue, but doesn't cover exposed tooth roots to any great extent.
In cases of root exposure, dentists usually prefer another type of procedure, known as connective tissue grafting. The donor tissue is usually taken again from the palate, but the design of the surgery is different. A flap of tissue at the recipient site is opened so that after the connective tissue from the palate is placed at the recipient site to cover the exposed roots, the flap of tissue covers the graft to provide blood circulation to the graft as it heals.
Both kinds of procedures, particularly the latter, require detailed precision by a skilled and experienced surgeon. Although they can successfully reverse gum recession, it's much better to avoid a gum infection in the first place with daily oral hygiene and regular dental care.
If you would like more information on treating gum recession, 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 Plastic Surgery.”
Dental plaque, that gritty bacterial film coating your teeth, is the top cause for tooth decay and periodontal (gum) disease. You can see and feel a lot of it—but not all of it. Some deposits can lodge snugly between your teeth, and can cause dental disease just as much as what's out in the open.
The problem with between-teeth plaque is that even a solid brushing habit might not effectively remove it. That's why you flossing should also be part of your daily oral hygiene.
If the thought of flossing, however, causes you to let out an audible sigh, we understand. Flossing typically engenders less enthusiasm than brushing, mainly because many find flossing time consuming and difficult to do.
If traditional flossing isn't your bag, we may have a reasonable alternative. Oral irrigation is a hygiene method for removing plaque between teeth using a pressurized water spray. You direct the water spray between your teeth using a handheld wand (which somewhat resembles a power toothbrush) and small hose attached to a countertop pump appliance.
A mainstay in dental offices, oral irrigators (or water flossers) have been available for home use since the 1960s. They're ideal for people who have problems with manual dexterity or who may not want to contend with flossing thread. They also make it easier for patients wearing braces to clean between their teeth, a monumental task using regular floss.
As to effectiveness, oral irrigation appears to match that of regular flossing, especially for orthodontic patients. Clinical studies in the early 2000s compared patients with braces using oral irrigation with those who were brushing only. Those using irrigation were able to remove five times as much plaque as the other group.
There are a number of comparable oral irrigation brands on the market from which to choose, and your dentist can advise you on features to look for when purchasing one. Just be sure you're using some method, oral irrigation or traditional flossing, to remove disease-causing plaque from between your teeth—either will go a long way in keeping your teeth and gums healthy.
If you would like more information on flossing methods, 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 “Cleaning Between Your Teeth.”
Getting dental implants is going to require surgery. But don't let that concern you—it's a relatively minor procedure.
Currently the “gold standard” for tooth replacement, an implant consists of a titanium post surgically imbedded in the jawbone. We can affix a life-like crown to a single implant or support a fixed bridge or removable denture using a series of them.
Because placement will determine the restoration's final appearance, we must carefully plan implant surgery beforehand. Our first priority is to verify that you have adequate jawbone available to support an implant.
Additionally, we want to identify any underlying structures like nerves or blood vessels that might obstruct placement. We may also develop a surgical guide, a retainer-like device placed in the mouth during surgery that identifies precisely where to create the holes or channels for the implants.
After numbing the area with local anesthesia, we begin the surgery by opening the gum tissue with a series of incisions to expose the underlying bone. If we've prepared a surgical guide, we'll place it in the mouth at this time.
We then create the channel for the insert through a series of drillings. We start with a small opening, then increase its size through subsequent drills until we've created a channel that fits the size of the intended implant.
After removing the implant from its sterile packaging, we'll directly insert it into the channel. Once in place, we may take an x-ray to verify that it's been properly placed, and adjust as needed. Unless we're attaching a temporary crown at the time of surgery (an alternate procedure called immediate loading), we suture the gums over the implant to protect it.
Similar to other dental procedures, discomfort after surgery is usually mild to moderate and manageable with pain relievers like acetaminophen or ibuprofen (if necessary, we can prescribe something stronger). We may also have you take antibiotics or use antibacterial mouthrinses for a while to prevent infection.
A few weeks later, after the bone has grown and adhered to the implant surface, you'll return to receive your new permanent crown or restoration. While the process can take a few months and a number of treatment visits, in the end you'll have new life-like teeth that could serve you well for decades.
If you would like more information on dental implants, 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 “Dental Implant Surgery.”
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