If you wince in pain while eating or drinking something hot or cold, you’re not alone: tooth sensitivity afflicts one in three Americans. To understand what’s possibly going on, let’s look first at tooth anatomy.
Teeth are mainly composed of three layers: an outer protective enamel that covers the upper crown, a middle layer called dentin and an inner pulp. The dentin is composed of small tubules that transmit outer temperature and pressure sensations to nerves in the pulp.
The enamel serves as a “muffler,” damping sensations to protect the nerves from overload. In the root area, the gums and a thin material called cementum covering the roots also help muffle sensation.
But sometimes teeth can lose this muffling effect and the nerves encounter the full brunt of the sensations. The most common reason is gum recession, usually caused by periodontal (gum) disease. The gums have shrunk back or “receded,” and after a short while the cementum covering will also be lost, exposing the dentin in the root area.
Another problem is enamel erosion caused by mouth acid. Chronic high acidity, often caused by bacterial growth or acidic foods and beverages, can dissolve the enamel’s mineral content, causing decay and exposure as well of the underlying dentin.
To avoid future tooth sensitivity, it pays to prevent these two dental problems. The most important thing you can do is practice daily brushing and flossing to reduce bacterial plaque and see your dentist regularly for dental cleanings and checkups.
But if you’re already experiencing symptoms, you’ll first need an accurate diagnosis of the cause. If it’s related to gum disease, immediate treatment could help stop or even reverse any gum recession. To address enamel erosion, your dentist may be able to protect and strengthen your teeth with sealants and topical fluoride.
There are also things you and your dentist can do to reduce your symptoms. One is for you to use hygiene products with fluoride, which can take the edge off of sensitivity, or potassium, which helps reduce nerve activity. Your dentist can further reduce nerve sensitivity by blocking the tubules with sealants and bonding agents.
Tooth sensitivity is an irritating problem in itself; more importantly, though, it’s often a warning of something else seriously wrong that needs attention. If you’re feeling a little sensitive in the teeth, see your dentist as soon as possible.
If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity: Understanding Your Options.”
To have a beautiful, healthy smile you’ll need to keep those pearly whites clean and plaque-free. Good dental hygiene, though, isn’t a solo act: It’s a duet best performed by you and your dental health provider. While you’re responsible for brushing and flossing every day, your dental hygienist gives your teeth a thorough cleaning every six months (or more). The American Dental Hygienists Association commemorates every October as National Dental Hygiene Month to recognize both the importance of hygiene and the professionals who assist you in keeping your teeth as clean as possible.
The focus for this emphasis on brushing, flossing and professional cleaning? A slick, slimy substance called dental plaque. This thin film of bacteria and food particles builds up on tooth surfaces after eating and gives rise to infections that cause tooth decay and gum disease. And it doesn’t take long without proper brushing and flossing, for a gum infection called gingivitis to start in only a matter of days. Daily hygiene reduces your risk of that happening: Brushing removes plaque from the broad, biting surfaces of the teeth, while flossing takes care of the areas between teeth that brushing can’t access.
So, if you can remove most of the plaque yourself, why see a dental hygienist? For two reasons: First, while daily hygiene takes care of the lion’s share of plaque, it’s difficult to clear away all of it. Over time, even a small amount of missed plaque can increase your disease risk. However, a professional cleaning that uses special hand tools and ultrasonic equipment can easily clean away this leftover plaque.
Second, some of the soft plaque can interact with saliva to form a hardened, calcified form called calculus or tartar. It can harbor bacteria just like the softer version, and it’s next to impossible to dislodge with brushing and flossing. Again, a trained hygienist with the right tools can effectively break up and remove calculus.
There are also additional benefits that come from regular dental visits to your hygienist. For one, hygienists can provide practical instruction and tips to help you brush and floss more effectively. And, after cleaning your teeth, they can point out areas with heavy plaque and calculus deposits. That can help you focus more of your future brushing and flossing efforts on those areas.
So, a shout-out to all the dental hygienists out there: These dedicated professionals work hard to keep your teeth clean. And a big high-five to you, too: Without your daily commitment to brushing and flossing, your smile wouldn’t be as beautiful—and healthy.
If you would like more information about best dental hygiene practices, please contact us to schedule a consultation. To learn more, read the Dear Doctor magazine articles “Dental Hygiene Visit” and “10 Tips for Daily Oral Care at Home.”
The Golden Globes ceremony is a night when Hollywood stars shine their brightest. At the recent red-carpet event, leading man Viggo Mortensen had plenty to smile about: Green Book, the movie in which he co-starred, picked up the award for Best Motion Picture—Musical or Comedy. But fans looking at the veteran actor's big smile today might not realize that it once looked very different. A few years ago, an accident during the filming of The Two Towers took a major chip out of Mortensen's front tooth!
That might be OK for some movies (think The Hangover or Dumb and Dumber)—but it's not so great for everyday life. Fortunately, Mortensen visited a dentist promptly, and now his smile is picture-perfect. How was that accomplished? He didn't say…but generally, the best treatment for a chipped tooth depends on how much of the tooth's structure is missing.
If the tooth has only a small chip or crack, it's often possible to restore it via cosmetic bonding. This procedure can be done right in the dental office, frequently in a single visit. Here's how it works: First the tooth is cleaned and prepared, and then a tooth-colored resin is applied to the area being restored. After it is cured (hardened) with a special light, additional layers may be applied to build up the missing structure. When properly cared for, a tooth restored this way can look good for several years.
For a longer-lasting restoration, veneers may be recommended. These are wafer-thin shells made of durable material (most often porcelain) that cover the front (visible) surfaces of teeth. Strong and lifelike, veneers can match the exact color of your natural teeth—or give you the bright, high-wattage smile you've always wanted. No wonder they're so popular in Hollywood! Because veneers are custom-made for you, getting them may require several office visits.
If a chip or crack extends to the inner pulp of the tooth, a root canal procedure will be needed to keep the tooth from becoming infected—a situation that could have serious consequences. But you shouldn't fear a root canal! The procedure generally causes no more discomfort than filling a cavity (though it takes a little longer), and it can help save teeth that would otherwise be lost. After a root canal, a crown (cap) is generally needed to restore the visible part of the tooth.
When a damaged tooth can't be restored, it needs to be extracted (removed) and replaced. Today's best option for tooth replacement is a dental implant—a small, screw-shaped post inserted into the bone of your jaw that anchors a lifelike, fully functional crown. Implants require very little special care and can look great for many years, making them a top choice for tooth replacement
If you have questions about chipped or damaged teeth, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Artistic Repair Of Front Teeth With Composite Resin” and “Porcelain Veneers.”
The Millennials, those born around the turn of the Millennium in 2000, are entering adulthood. Like any generation, they have their collective promise—and problems. An example of the latter seems to involve their teeth: an estimated one in three people between the ages of 18 and 34 have some form of tooth decay.
If a recent survey is correct, that may be a result of poor oral hygiene practices. The absence of a consistent, daily habit of brushing and flossing to remove disease-causing dental plaque is the number one cause for dental disease. But a survey of 2,000 millennials found only three in ten brushed their teeth at least once a day with many often skipping brushing for two or more days a time.
Interestingly, more than half of the survey also reported an aversion to dental visits. That will likely need to change if these trends in poor hygiene continue, as aging millennials will eventually need extensive treatment for tooth decay and its close counterpart periodontal (gum) disease to save their teeth. Dental professionals recommend a different dental care track: stop dental disease before it develops. And the key to that is a simple but powerful daily brushing and flossing routine.
This routine should involve brushing teeth up to twice and flossing at least once a day. Brushing should be done with gentle strokes, but include all exposed tooth surfaces (about two minutes to perform a thorough job). Flossing is less popular than brushing, but it’s essential for removing plaque between teeth your brush can’t reach. To make it easier, you can use pre-threaded floss or a water flosser that removes plaque with a stream of water.
To round out your prevention strategy, you should see a dentist at least twice a year for professional cleanings of hardened plaque deposits (calculus), as well as overall monitoring of your dental health. And if dental visits make you anxious, your dental professional has a number of ways to help you relax.
One thing’s for sure: like any other generation, millennials prize both good health and an attractive smile. Adopting a solid oral hygiene lifestyle will do the most to achieve both.
Around 20 million people—mostly women after menopause—take medication to slow the progress of osteoporosis, a debilitating disease that weakens bones. But although effective, some osteoporosis drugs could pose dental issues related to the jawbones.
Osteoporosis causes the natural spaces that lie between the mineral content of bone to grow larger over time. This makes the bone weaker and unable to withstand forces it once could, which significantly increases the risk of fracture. A number of drugs have been developed over time that stop or slow this disease process.
Two of the most prominent osteoporosis drugs are alendronate, known also by its trade name Fosamax, and denosumab or Prolia. While originating from different drug families, alendronate and denosumab work in a similar way by destroying specialized bone cells called osteoclasts that break down worn out bone and help dissolve it. By reducing the number of these cells, more of the older bone that would have been phased out lasts longer.
In actuality this only offers a short-term benefit in controlling osteoporosis. The older bone isn’t renewed but only preserved, and will eventually become fragile and more prone to fracture. After several years the tide turns negatively for the bone’s overall health. It’s also possible, although rare, that the bone simply dies in a condition called osteonecrosis.
The jawbones are especially susceptible to osteonecrosis. Forces generated by chewing normally help stimulate jawbone growth, but the medications in question can inhibit that stimulus. As a result the jawbone can diminish and weaken, making eventual tooth loss a real possibility.
Osteonecrosis is most often triggered by trauma or invasive dental procedures like tooth extractions or oral surgery. For this reason if you’re taking either alendronate and denosumab and are about to undergo a dental procedure other than routine cleaning, filling or crown-work, you should speak to your physician about suspending your medication temporarily. Dentists often recommend a suspension of three to nine months before the procedure and three months afterward.
Some research indicates this won’t worsen your osteoporosis symptoms, especially if you substitute another treatment or fortify your skeletal system with calcium and vitamin D supplements. But taking this temporary measure could help protect your teeth in the long run.
If you would like more information on the effect of osteoporosis treatment on dental health, 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 “Osteoporosis Drugs & Dental Treatment.”
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