ThatToothacheMightNotBeFromYourToothTheProblemofReferredPain

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.

If you would like more information on dental pain, please contact us or schedule an appointment for a consultation.

By John W. Cox DDS
March 22, 2020
Category: Oral Health
Tags: tooth wear  
KeepanEyeonTheseFourThingstoPreventAbnormalToothWear

Teeth are naturally strong and durable — if we can prevent or control dental disease like tooth decay or gum disease, they can last a lifetime. Still, teeth do wear gradually as we age, a fact we must factor into our dental care as we grow older.

Sometimes, though, the wear rate can accelerate and lead to problems much earlier — even tooth loss. There are generally four ways this abnormal wear can occur.

Tooth to tooth contact. Attrition usually results from habitual teeth grinding or clenching that are well beyond normal tooth contact. Also known as bruxism, these habits may occur unconsciously, often while you sleep. Treatments for bruxism include an occlusal guard worn to prevent tooth to tooth contact, orthodontic treatment, medication, biofeedback or psychological counseling to improve stress coping skills.

Teeth and hard material contact. Bruxism causes abrasion when our teeth regularly bite on hard materials such as pencils, nails, or bobby pins. The constant contact with these and other abrasive surfaces will cause the enamel to erode. Again, learning to cope with stress and breaking the bruxism habit will help preserve the remaining enamel.

Chronic acid. A high level of acid from foods we eat or drink can erode tooth enamel. Saliva naturally neutralizes this acid and restores the mouth to a neutral pH, usually within thirty minutes to an hour after eating. But if you’re constantly snacking on acidic foods and beverages, saliva’s buffering ability can’t keep up. To avoid this situation, refrain from constant snacking and limit acidic beverages like sodas or sports drinks to mealtimes. Extreme cases of gastric reflux disease may also disrupt your mouth’s pH — seek treatment from your medical doctor if you’re having related symptoms.

Enamel loss at the gumline. Also known as abfraction, this enamel loss is often caused by receding gums that expose more of the tooth below the enamel, which can lead to its erosion. Preventing and treating gum disease (the leading cause of receding gums) and proper oral hygiene will lower your risks of receding gums and protect tooth enamel.

If you would like more information on tooth wear, 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 “How and Why Teeth Wear.”

By John W. Cox DDS
March 12, 2020
Category: Oral Health
Tags: tooth pain  
SeeYourDentisttoFindouttheRealCauseforYourToothPain

If you have tooth pain, we want to know about it. No, really—we want to know all about it. Is the pain sharp or dull? Is it emanating from one tooth or more generally? Is it constant, intermittent or only when you bite down?

Dentists ask questions like these because there are multiple causes for tooth pain with different treatment requirements. The more accurate the diagnosis, the quicker and more successful your treatment will be.

Here are 3 different examples of tooth pain, along with their possible causes and treatments.

Tooth sensitivity. If you feel a quick jolt of pain when you eat or drink something hot or cold, it may mean your gums have drawn back (receded) from your teeth to leave more sensitive areas exposed. Gum recession is most often caused by gum disease, which we can treat by removing dental plaque, the main cause for the infection. In mild cases the gums may recover after treatment, but more advanced recession may require grafting surgery.

Dull ache around upper teeth. This type of pain might actually be a sinus problem, not a dental one. The upper back teeth share some of the same nerves as the sinus cavity just above them. See your dentist first to rule out deep decay or a tooth grinding habit putting too much pressure on the teeth. If your dentist rules out an oral cause, you may need to see your family physician to check for a sinus infection.

Constant sharp pain. A throbbing pain seeming to come from one tooth may be a sign the tooth's central pulp layer has become decayed. The resulting infection is attacking the pulp's nerves, which is causing the excruciating pain. Advanced decay of this sort requires a root canal treatment to remove the diseased tissue and fill the empty pulp chamber and root canals to prevent further infection. See your dentist even if the pain stops—the infection may have only killed the nerves, but is still present and advancing.

Pain is the body's warning system—so heed the tooth pain alert and see your dentist as soon as possible. The sooner the problem is identified and treated, the better your chances of returning to full dental health.

If you would like more information on tooth pain and what it means, 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 “Tooth Pain? Don't Wait!

HughJackmanIsAllSmilesforHisNewBroadway-InspiredShow

To anyone immersed in the “X-Men Universe” Hugh Jackman will always be Wolverine, a role he played in seven movies. But there’s more to this Australian actor than mutant bone claws and mutton chops that would make Elvis envious. Jackman has also starred in over 20 non-superhero films, including Les Misérables, for which he won a Golden Globe. He is also a Tony award-winning Broadway performer—with a winning smile.

With his famed character Logan/Wolverine fading in the rearview mirror, Jackman has returned to his musical roots. He will play Harold Hill in the Broadway revival of The Music Man, set to open in Fall 2020. And since May 2019 he’s been on world tour with Hugh Jackman: The Man. The Music. The Show., featuring Jackman and a supporting cast performing songs from favorite shows and films, including Les Misérables and the 2017 hit The Greatest Showman.

The Show, with 90 planned stops throughout Europe, North America and Oceania, is a decidedly different “universe” from the X-Men. As Wolverine, Jackman could get away with a scruffier look. But performing as Jean Valjean or the bigger-than-life P.T. Barnum, he has to bring a vastly different look to the role, which brings us to Jackman’s teeth…

Once upon a time, Jackman’s teeth were an unflattering gray—definitely not a good look for stage or film. So with the help of his dentist, Jackman set about upgrading his smile with teeth whitening. Teeth whitening is a great way to take a dull, stained smile and turn up the volume on its brightness—and attractiveness—a notch or two. A dentist applies a bleaching solution that stays in contact with the teeth for a few minutes. The process is often aided by special lighting.

A professional application is especially desirable if, like Jackman, you want “Goldilocks” brightness: not too little, not too much, but just right for you. Dentists can precisely control the tint level to get a brighter but more naturally looking white. Of course, you can also get a dazzling “Hollywood” smile if you so desire.

And although the effect of teeth whitening isn’t permanent, a dental application can last a while, depending on how well you manage foods and beverages that stain teeth. With a touchup now and then, you may be able to keep your brighter smile for years before undergoing the full procedure again.

One important note, though: This technique only works with outer enamel staining. If the discoloration originates from within the tooth, the bleaching agent will have to be placed internally, requiring access to the inside of the tooth. An alternative would be porcelain veneers to mask the discoloration, an option that also works when there is ultra-heavy enamel staining.

If you’re tired of your dull smile, talk with us about putting some pizzazz back into it. Teeth whitening could be your way to get a smile worthy of Broadway.

If you would like more information about teeth whitening, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Teeth Whitening” and “Whitening Traumatized Teeth.”

By John W. Cox DDS
February 21, 2020
Category: Oral Health
Tags: dental injury  
CommonTypesofToothInjuriesandHowtoTreatThem

Although naturally resilient, your teeth still face some significant dangers. Tooth decay and gum disease, “enemies” within the mouth, can severely damage your teeth and eventually lead to their loss.

But there are also external dangers just as devastating — traumatic injuries that can happen in the blink of an eye. Fortunately, we can treat even the most serious of these injuries and increase the chances of an injured tooth’s survival.

Here are some of those common dental injuries:

Chipped or Fractured Teeth. This is a case where a part of the tooth has been broken but it’s still firmly rooted in the mouth. If small portions of the enamel or dentin (the next underlying layer of the tooth) have been chipped, we may be able to reattach them or fill the affected tooth area with a natural-colored filling (larger broken portions may require a complete crown). If the damage has injured or exposed the inner pulp, a root canal treatment might be in order to prevent infection and reduce pain.

Dislocated (Luxated) Teeth. A dislocation occurs when the impact moves the tooth in an abnormal way in the socket. We must first reposition the tooth and, if need be, stabilize it by splinting it to neighboring teeth. This type of injury may also require a root canal treatment.

Knocked out (Avulsed) Teeth. It’s quite possible to replant a knocked out tooth — if you act quickly. Without touching the root, the tooth should be rinsed with cold, clean water and then placed into the empty socket within five minutes of the injury. If placement isn’t possible, the tooth should be placed in a container with milk or with some of the injured person’s collected saliva (to keep the root from drying out), and sent with the injured person to treatment. We need to see the injured person as soon as possible to make sure the tooth is repositioned properly and take other measures to protect it. We’ll also need to monitor it for proper healing for awhile.

Although some injuries may be too severe to save a traumatized tooth, seeking immediate treatment certainly increases the chances for survival. If you or a family member experiences such an injury, keep calm and contact us immediately.

If you would like more information on treating dental injuries, 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 “Trauma & Nerve Damage to Teeth.”





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