Each year doctors treat about 150,000 new cases of severe facial pain. If you're one of those people, you don't have to suffer—there are ways to gain relief from these painful episodes.
Those recurring episodes are known as trigeminal neuralgia (TN). As the name implies, the source of the pain are the trigeminal nerves, which originate in the brain stem and extend on either side of the face. Each is divided into three branches (hence the "tri" in trigeminal) that serve the upper, middle and lower parts of the face and jaw.
TN can involve one or more of these branches, resulting in mild to severe pain that can last for several seconds. Jaw movements like chewing or speaking can trigger an episode, as well as a light touch to the face.
There are various proposed causes for TN, including links with inflammatory disorders like multiple sclerosis, which damages the insulating sheathing around nerve cells. The most common cause, though, appears to be a blood vessel pressing against the nerve. The compression causes hypersensitivity in that area of the nerve so that it transmits pain at the slightest sensation.
Other conditions like jaw joint pain disorders (TMD) or a dental abscess can cause similar pain symptoms, so it's important to get an accurate diagnosis. If your doctor does identify your condition as TN, you may then need a comprehensive approach to treatment involving a team of care providers, including your dentist.
For the most part, TN can be managed, beginning with the most conservative approach to gain relief, often with medications to block the nerve's pain signals to the brain or decrease abnormal nerve firings. If that proves insufficient, though, more intensive treatments are available.
One possible treatment for an impinging blood vessel is a microsurgical procedure to expose the affected nerve and relocate the vessel. While this can be effective, the surgery does carry some risk of facial numbness or decreased hearing. If the risks are too high for conventional surgery, an alternative procedure uses a precise beam of high-dose radiation to relieve the pressure from the vessel.
The most important thing to know about TN, though, is that it is possible to control it and relieve future pain episodes. If you're experiencing these symptoms, see your dentist or doctor for an exam and accurate diagnosis.
If you would like more information on trigeminal neuralgia, 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: A Nerve Disorder that Causes Facial Pain.”
While the sport of golf may not look too dangerous from the sidelines, players know it can sometimes lead to mishaps. There are accidents involving golf carts and clubs, painful muscle and back injuries, and even the threat of lightning strikes on the greens. Yet it wasn’t any of these things that caused professional golfer Danielle Kang’s broken tooth on the opening day of the LPGA Singapore tournament.
“I was eating and it broke,” explained Kang. “My dentist told me, I've chipped another one before, and he said, you don't break it at that moment. It's been broken and it just chips off.” Fortunately, the winner of the 2017 Women’s PGA championship got immediate dental treatment, and went right back on the course to play a solid round, shooting 68.
Kang’s unlucky “chip shot” is far from a rare occurrence. In fact, chipped, fractured and broken teeth are among the most common dental injuries. The cause can be crunching too hard on a piece of ice or hard candy, a sudden accident or a blow to the face, or a tooth that’s weakened by decay or repetitive stress from a habit like nail biting. Feeling a broken tooth in your mouth can cause surprise and worry—but luckily, dentists have many ways of restoring the tooth’s appearance and function.
Exactly how a broken tooth is treated depends on how much of its structure is missing, and whether the soft tissue deep inside of it has been compromised. When a fracture exposes the tooth’s soft pulp it can easily become infected, which may lead to serious problems. In this situation, a root canal or extraction will likely be needed. This involves carefully removing the infected pulp tissue and disinfecting and sealing the “canals” (hollow spaces inside the tooth) to prevent further infection. The tooth can then be restored, often with a crown (cap) to replace the entire visible part. A timely root canal procedure can often save a tooth that would otherwise need to be extracted (removed).
For less serious chips, dental veneers may be an option. Made of durable and lifelike porcelain, veneers are translucent shells that go over the front surfaces of teeth. They can cover minor to moderate chips and cracks, and even correct size and spacing irregularities and discoloration. Veneers can be custom-made in a dental laboratory from a model of your teeth, and are cemented to teeth for a long-lasting and natural-looking restoration.
Minor chips can often be remedied via dental bonding. Here, layers of tooth-colored resin are applied to the surfaces being restored. The resin is shaped to fill in the missing structure and hardened by a special light. While not as long-lasting as other restoration methods, bonding is a relatively simple and inexpensive technique that can often be completed in just one office visit.
If you have questions about restoring chipped teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Porcelain Veneers” and “Artistic Repair of Chipped Teeth With Composite Resin.”
Pain is the body’s warning system: It tells us something is wrong. And depending on the location and intensity of the pain, it can give us vital clues about the problem.
Sometimes, though, it’s not so clear and direct—the pain could arise from any number of sources. Toothaches often fall into this category: Although it’s likely indicating a tooth or gum problem, it could be something else — or even somewhere else.
This is known as referred pain, in which you may feel pain in one location, like your mouth, but the actual source of the problem is somewhere else, like an infected and congested sinus passage. If we’re able to identify the true source and location of the pain, the better the chances of a successful treatment outcome.
Besides sinus infections, there are other conditions like trigeminal neuralgia that can refer pain to the mouth. This painful condition involves the trigeminal nerve, a large nerve running on either side of the face that can become inflamed. Depending on where the inflammation occurs, you might feel the pain at various points along the jaw, feeling much like a toothache.
There’s also the case of an earache mimicking a toothache, and vice-versa. Because of the proximity of the ears to the jaws, there is some nerve interconnectedness between them. For example, an infected or abscessed back tooth could feel a lot like an earache.
These and other possible problems (including jaw joint disorders or teeth grinding) can generate pain as if it were coming from the mouth or a single tooth. To be sure you’ll need to undergo a complete dental examination. If your dentist doesn’t find anything wrong with your mouth, he or she may refer you to a medical doctor to explore other possible causes.
Getting to the root cause of pain can help determine which treatment strategy to pursue to relieve it. Finding the actual source is the most efficient way to understand what a pain sensation is trying to tell us.
A certain news story a few years ago notwithstanding, dentists still recommend flossing along with brushing to adequately remove disease-causing plaque. If there is any controversy at all about flossing, it's whether you should perform it before brushing or after. Each perspective has good reasons.
"Brush First" proponents say their way encourages the formation of a daily hygiene habit, a must for preventing disease. That's because brushing can remove most of the plaque built up on the teeth, while flossing can then remove what's left. If you floss first, though, you'll have to plow through the sticky film with the floss, which can be an unpleasant experience. Facing that every day could make a person less enthusiastic about developing a hygiene habit.
But it's not just about the sensation: depending on the person, the plaque buildup could be so much that the floss becomes clogged with it. You're then moving the plaque rather than removing it. Brushing a lot of the plaque out of the way first will increase the cleaning power of your floss.
The "Floss First" team, though, is undaunted with their own take on the matter. Flossing can loosen up any stuck debris between teeth, making it easier for brushing to clear it away. It can also expose plaque-covered areas between teeth to allow better contact with the fluoride in your toothpaste. And, the amount of plaque you're pulling out in certain areas during flossing could tip you off to beef up your brushing efforts on those areas of heavier plaque accumulation.
One of the prime reasons for flossing first, though, goes back to the comfort factor and human nature. To be honest, for most people flossing isn't as much "fun" as brushing. If you put it off until after brushing, you're more likely not to do it if you find it unpleasant. Doing it first gets the less likeable task out of the way, so you can then do the more likeable one, brushing.
Which approach is best for you? It's really a personal decision, one you can discuss with your dentist. Try both ways, and see which one seems better. But whether you floss first or last, do floss to really reduce your risk for dental disease.
If you would like more information on best oral hygiene practices, 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 “Brushing and Flossing: Which Should be Done First?”
It’s July—and that means it’s National Park and Recreation Month! If you’re like a lot of families, you might already be planning a trip to one of the nation’s 58 national parks, or one of the thousands of state outdoor recreational areas across the country.
Temporarily escaping the stresses of daily life in the great outdoors is a wonderful way to refresh both the soul and the body. But that’s not an excuse to neglect all your responsibilities. That includes making provisions to care for your teeth while you’re away from home—you are bringing them with you, aren’t you?
Here are three ways you can take care of your teeth during your outdoor getaway.
Keep up your daily hygiene. While you’re packing extra socks, granola and moleskin, be sure to include your toothbrush, toothpaste and floss. Just a few days of neglecting your regular oral hygiene can give bacterial plaque a chance to build up. You could even come back from your trip with the beginnings of gingivitis, an early form of gum disease. If you’re trying to pack light, take along travel-size toothpaste tubes or pre-threaded floss picks to make it easier.
Eat dental-friendly snacks and food. Escaping your usual dietary choices doesn’t mean you should take a vacation from good nutrition. Whether you’re in camp or on the trail, eat whole fruits, grains or cheeses, and avoid snacks and foods with added sugar that feeds disease-causing bacteria in the mouth. The same goes for beverages—keep your intake of sodas and sports or energy drinks (all loaded with added sugar and acid) to a bare minimum. Instead, hydrate with water.
Be prepared for emergencies. Exploration through hiking, canoeing and other physical activities is a great part of the outdoor park experience. But it also increases your risk of injury, especially in rough terrain. Before you head out, take some time to research medical and dental resources near your vacation destination in case you or a family member will need immediate care. Having that information handy can save time in the event of an emergency.
An outdoor park trip can be the experience of a lifetime. Just be sure to follow these simple tips to care for and protect your teeth. Doing so will help ensure that your memories of this summer’s outing will be pleasant ones.
If you would like more information about caring for your dental health at home or away, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Daily Oral Hygiene.”
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