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Posts for tag: tooth pain

By Gregory L Palozola D.D.S. P.C.
January 06, 2018
Category: Oral Health
Tags: tooth pain  
BeforeweExtractThatProblemToothLetsConsiderSavingit

Even though an implant is now as close to life-like as modern dentistry can produce, it won’t surpass the function of your own natural tooth. That’s not to say implants are an inferior choice—in fact, it’s often the best one if a tooth is beyond reasonable repair. But first, let’s consider saving your existing tooth.

We first need to know why your tooth is diseased—more than likely either from tooth decay or periodontal (gum) disease. Although different, these infections both begin with bacteria and can eventually lead to tooth loss.

While your mouth is teeming with millions of harmless bacteria, a few strains that live in dental plaque (a thin biofilm on your teeth) can cause disease. As they proliferate—feeding mostly on leftover sugar—they produce acid, which can erode the protective enamel on teeth. This can create cavities, which must be cleared of decayed material and filled.

Sometimes, though, the decay spreads deep within the pulp and through the root canals putting the tooth in danger. We may be able to save it, though, with a root canal treatment. In this common procedure we access the pulp chamber and clean out all the diseased or dead tissue. We then fill the empty chamber and root canals with a gutta percha filling and then seal the tooth. We later cap the tooth with a crown to further protect it.

Dental plaque can also give rise to a gum infection that triggers chronic inflammation. The inflammation can cause the gums to weaken and detach from the teeth to form large, infection-filled voids called periodontal pockets. This could lead to bone deterioration, further loosening the tooth’s hold.

But we can effectively treat gum disease by removing the plaque, which is fueling the infection. We normally do this with special hand instruments, but may also need to use surgical measures for more advanced cases. After plaque removal the inflammation subsides, giving the tissues a chance to heal and strengthen. We may also need to provide further assistance to these tissues to regenerate through gum or bone grafting.

These efforts can be quite involved, but if successful they could give your tooth another lease on life. And that could be a much better outcome for your dental health.

If you would like more information on the best treatment choices for your 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 “Save a Tooth or Get an Implant?

By Gregory L Palozola D.D.S. P.C.
December 29, 2017
Category: Dental Procedures
CharlizeTheronBackinActionAfterDentalSurgery

When they’re introducing a new movie, actors often take a moment to pay tribute to the people who helped make it happen — like, you know, their dentists. At least that’s what Charlize Theron did at the premiere of her new spy thriller, Atomic Blonde.

"I just want to take a quick moment to thank my dentists," she told a Los Angeles audience as they waited for the film to roll. "I don’t even know if they’re here, but I just want to say thank you."

Why did the starring actress/producer give a shout-out to her dental team? It seems she trained and fought so hard in the action sequences that she actually cracked two teeth!

“I had severe tooth pain, which I never had in my entire life,” Theron told an interviewer from Variety. At first, she thought it was a cavity — but later, she found out it was more serious: One tooth needed a root canal, and the other had to be extracted and replaced with a dental implant — but first, a bone grafting procedure was needed. “I had to put a donor bone in [the jaw] to heal,” she noted, “and then I had another surgery to put a metal screw in there.”

Although it might sound like the kind of treatment only an action hero would need, bone grafting is now a routine part of many dental implant procedures. The reason is that without a sufficient volume of good-quality bone, implant placement is difficult or impossible. That’s because the screw-like implant must be firmly joined with the jawbone, so it can support the replacement tooth.

Fortunately, dentists have a way to help your body build new bone: A relatively small amount of bone material can be placed in the missing tooth’s socket in a procedure called bone grafting. This may come from your own body or, more likely, it may be processed bone material from a laboratory. The donor material can be from a human, animal or synthetic source, but because of stringent processing techniques, the material is safe for human use. Once it is put in place your body takes over, using the grafted material as a scaffold on which to build new bone cells. If jawbone volume is insufficient for implants, it can often be restored to a viable point in a few months.

Better yet, when grafting material is placed in the tooth socket immediately after extraction, it can keep most of the bone loss from occurring in the first place, enabling an implant to be placed as soon as possible — even before the end of a movie’s shooting schedule.

Will Atomic Blonde prove to be an action-movie classic? Only time will tell. But one thing’s for sure: When Charlize Theron walks down the red carpet, she won’t have to worry about a gap in her smile.

If you have questions about bone grafting or dental implants, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Immediate Dental Implant.”

By Gregory L Palozola D.D.S. P.C.
October 22, 2015
Category: Oral Health
Tags: tooth pain  
FindandTreattheActualSourceofToothPaintoRelieveit

Determining which of your teeth is causing your toothache isn’t always easy — or even if it’s a tooth at all. The pain could be coming from a tooth, the gums, or both. Only a thorough dental examination can pinpoint the exact cause and best course of treatment.

If a decayed tooth is the problem, the pain may be coming from nerves and other tissue deep within the tooth’s pulp. The symptoms could be dull or sharp, constant or intermittent, specific to one area or spread out. It’s even possible for the pain to suddenly subside after a few days. This doesn’t mean the infection has subsided, but rather that the infected nerves have died and no longer transmit pain. Pain can also radiate from the actual source and be felt somewhere else — the pain in your sinuses, for example, could actually originate from an infected back tooth.

If the source is periodontal (gum) disease, the infection has begun in the gum tissues. As they become more inflamed they lose their connectivity with the teeth, bone loss occurs and the gums may “recess” or draw back. This exposes the tooth root, which without the protective cover of the gum tissues becomes highly sensitive to changes in temperature or pressure. As a result you may encounter sharp pain when you eat or drink something hot or cold, or bite down.

Treating these issues will depend on the actual infection source. An infected tooth often requires a root canal treatment to clean out the pulp and root canals of dead or infected tissue, fill them with a special filling, and seal and crown the tooth to prevent future infection. If the source is gum disease, we must manually remove the bacterial plaque causing the disease from all tooth and gum surfaces to stop the infection and allow the gums to heal. In advanced cases, surgical procedures may be necessary to repair damage and encourage new gum and bone growth.

Where dental disease has spread from tooth to gums or vice-versa, you may need treatments for both areas to address your overall condition. Whatever the treatment course, we can put an end to your tooth pain and restore health to your teeth and gums.

If you would like more information on the sources of mouth pain, please contact us today to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Confusing Tooth Pain.”

By Gregory L Palozola D.D.S. P.C.
May 27, 2014
Category: Oral Health
Tags: tooth pain   sensitive teeth  
GettingtotheRootofToothSensitivity

An icy cold beverage on a hot day or a steaming cup of cocoa on a frigid day are some of the simple pleasures in life. So why do they sometimes seem to turn against you and send sharp, sudden pain shooting through your teeth?

When pain affects your teeth, it's because the nerves within the very center portion, the “pulp,” are reacting to a stimulus such as temperature, pressure changes, or acidic or sugary substances. In healthy teeth, the pulp is protected from stimuli. Above the gum line, a layer of enamel encases and protects the visible portion of tooth (crown). Below, the gums (gingiva) and a thin layer of “cementum” protect the root portion. Neither of these contains nerves. However, directly under the enamel and cementum, surrounding the interior pulp, is the “dentin.” This layer contains nerve fibers that can relay sensations to the nerves in the pulp, which respond as they are designed to — with an unpleasant feeling that tells you something's wrong.

That feeling can range from a momentary pang, to prolonged dull throbbing, to downright excruciating distress. The nature of the pain depends on the type and degree of stimulus. The only way to be certain of what's causing the pain is with a professional dental examination. However, your symptoms can hint at some possible sources.

Fleeting sensitivity triggered by hot and cold foods generally does not indicate a serious problem. It may be due to any of the following:

  1. a small area of decay in a tooth,
  2. a loose filling,
  3. an exposed root surface resulting from gum recession (often due to improper or excessive brushing), or
  4. temporary pulp tissue irritation from recent dental work.

To help alleviate root sensitivity, make sure the tooth is free of dental bacterial plaque by brushing gently no more than twice a day. Fluoride-containing toothpaste made for sensitive teeth might help. Fluoride and additives such as potassium nitrate or strontium chloride help relieve sensitivity. Try using the toothpaste like a balm, gently rubbing it into the tooth surface for about 10 minutes. If the sensitivity is related to recent dental work, it should resolve within a few days to a week or two, depending on the extent of the work you had done. A mild over-the-counter pain reliever may help in the meantime.

No matter what the reason, if the sensitivity persists or worsens, please come see us. Together we'll get to the root of the underlying problem and resolve it so you can get back to enjoying the foods and beverages you love, no matter what the temperature!

If you would like more information about tooth sensitivity and ways to prevent or treat it, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Sensitive Teeth” and “Tooth Pain? Don't Wait!

By Gregory L Palozola D.D.S. P.C.
November 25, 2013
Category: Oral Health
Tags: tooth pain  
ConfusingToothPain

Is it a root canal problem, a gum infection, or both?

Sometimes it's difficult to pinpoint the source of tooth pain; it can result from an infection of the tooth itself, or of the gum, or even spread from one to the other. Identifying the origin of a toothache is important, however, so we can choose the right treatment and do all that we can to save the tooth.

When a tooth becomes decayed, bacteria can infect the sensitive, living nerve tissue deep inside the tooth known as the root canal. This condition is called an endodontic (“endo” – inside; “dont” – tooth) problem. The infection inside the tooth can spread to the periodontal ligament (“peri” – around; “dont” – tooth) that encases the tooth and attaches it to the jawbone. Occasionally, infection of endodontic (root canal) origin can spread out from the end of the tooth root all the way up the periodontal ligament, and into the gum.

The reverse can also happen: dental pain can originate from periodontal (gum) tissues that have become diseased. Gum disease is caused by a buildup of bacterial biofilm (plaque) along the gum line. It results in detachment of the gums along the tooth surface. In advanced cases, this bacterial infection can travel into the nerve tissues of the dental pulp through accessory canals or at the end of a tooth.

To figure out where pain is coming from when the source is not obvious, we need to take a detailed history of the symptoms, test how the tooth reacts to temperature and pressure, and evaluate radiographs (x-ray pictures).

Unfortunately, once dental disease becomes a combined periodontal-endodontic problem, the long-term survival of the tooth is jeopardized. The chances for saving the tooth are better if the infection started in the root canal and then spread to the gums, rather than if it started as gum disease that spread into the root canal of the tooth. That's because in the latter case, there is usually a lot of bone loss from the gum disease. Effectively removing plaque from your teeth on a daily basis with routine brushing and flossing is your best defense against developing gum disease in the first place.

If you would like more information about tooth pain, gum disease or root canal problems, please contact us or schedule an appointment for a consultation. You can also learn more about this diagnostic dilemma by reading Dear Doctor magazine's article “Confusing Tooth Pain.”