Posts for: June, 2018

By Randall J. Bartoe, DDS, PLC
June 21, 2018
Category: Oral Health
Tags: tooth pain   toothache  
3TypesofToothPainandWhatTheyMightbeTellingYou

Physical pain is never pleasant or welcomed. Nevertheless, it’s necessary for your well-being—pain is your body telling you something isn’t right and needs your attention.

That fully applies to tooth pain. Not all tooth pain is the same—the intensity, location and duration could all be telling you one of a number of things that could be wrong. In a way, pain has its own “language” that can give us vital clues as to what’s truly causing it.

Here are 3 types of tooth pain and what they might be telling you about an underlying dental problem.

Sensitivity to hot or cold. If you’ve ever had a sharp, momentary pain after consuming something hot like coffee or cold like ice cream, this could indicate several causative possibilities. You might have a small area of tooth decay or a loose filling. You might also have an exposed root due to gum recession, which is much more sensitive to temperature or pressure changes. The latter is also a sign of periodontal (gum) disease.

Acute or constant pain. If you’re feeling a severe and continuing pain from one particular area of your teeth (even if you can’t tell exactly which one), this could mean the pulp, the tooth’s innermost layer, has become infected with decay. The pain is emanating from nerves within the pulp coming under attack from the decay. To save the tooth, you may need a root canal treatment to remove the decayed tissue and seal the tooth from further infection. You should see your dentist as soon as possible, even if the pain suddenly stops—that only means the nerves have died, but the decay is still there and threatening your tooth.

┬áSevere gum pain. If there’s an extremely painful spot on your gums especially sensitive to touch, then you may have an abscess. This is a localized area of infection that develops in the gums either as the result of periodontal (gum) disease, or an infection spreading from the tooth pulp into the gum tissues. You’ll need to see a dentist immediately for both pain relief and appropriate treatment (including a possible root canal) to heal the abscessed tissue.

If you would like more information on tooth pain and how to 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 article “Tooth Pain? Don’t Wait!


By Randall J. Bartoe, DDS, PLC
June 11, 2018
Category: Oral Health
NoGleeinToothGrinding

Sure, it’s big news when celebs tweet selfies from the dental office… if you’re still living in the 20th century. But in Hollywood today, it’s harder to say who hasn’t posted snaps of themselves in the dentist’s chair than who has. Yet the pictures recently uploaded to Twitter by Mark Salling, the actor and singer who regularly appears as Noah “Puck” Puckerman on the popular TV series Glee, made us sit up and take notice.

“Getting my chipped tooth fixed. Also, apparently, I’m a big grinder,” read the caption. The photo showed a set of upper front teeth with visible chips on the biting surface. What’s so special about this seemingly mundane tweet? It’s a great way of bringing attention to a relatively common, but often overlooked problem: teeth clenching and grinding, also called bruxism.

Although bruxism is a habit that affects scores of people, many don’t even realize they have it. That’s because the condition may only become active at night. When the teeth are unconsciously ground together, the forces they produce can wear down the enamel, cause chipping or damage to teeth or dental work (such as veneers or fillings), or even loosen a tooth! While it’s common in children under 11 years old, in adults it can be a cause for concern.

Sometimes, mouth pain, soreness and visible damage alert individuals to their grinding habits; other times, a dental professional will notice the evidence of bruxism during an exam or cleaning: tooth sensitivity and telltale wear and tear on the chewing surfaces. Either way, it’s time to act.

Bruxism is most often caused by stress, which can negatively impact the body in many ways. It may also result from bite problems, the overuse of stimulating substances (caffeine, alcohol, tobacco, and illegal drugs), and as a side effect of certain medications. Sometimes, simply becoming aware of the habit can help a person get it under control. Common methods of stress reduction include exercise, meditation, a warm bath or a quiet period before bedtime; these can be tried while we monitor the situation to see if the problem is going away.

If stress reduction alone doesn’t do the trick, several other methods can be effective. When bruxism is caused by a minor bite problem, we can sometimes do a minor “bite adjustment” in the office. This involves removing a tiny bit of enamel from an individual tooth that is out of position, bringing it in line with the others. If it’s a more serious malocclusion, orthodontic appliances or other procedures may be recommended.

When grinding is severe enough to damage teeth or dental work, we may also recommend a custom-made night guard (occlusal guard), which you put in your mouth at bedtime. Comfortable and secure, this appliance prevents your teeth from being damaged by contacting each other, and protects your jaw joints from stresses due to excessive grinding forces.

Whether or not you have to smile for a living, teeth grinding can be a big problem. If you would like more information about this condition, call our office to schedule a consultation for a consultation.


By Randall J. Bartoe, DDS, PLC
June 01, 2018
Category: Dental Procedures
Tags: dental implants  
GoodBoneHealthEssentialforObtainingTeethinOneDayImplants

You've seen ads for “Teeth in One Day” that promise immediate implant placement at the same time you have the problem tooth removed. But this presumes the gums and underlying bone are healthy and able to support and protect the implant. If that's not the case, it may be ill-advised to place an implant on the same day.

Even with immediate placement, there will be a small degree of bone and gum opening or space around the implant after it's placed into the socket. This can often be remedied by placing a bone graft and sometimes a gum graft when we install the implant. It's also possible for natural healing to gradually fill in the space, but we'll need to monitor the site carefully for several weeks.

On the other hand, if we detect significant bone loss (or strongly suspect it will occur), immediate placement may not be an option — there's not enough bone or it's too weak to support an implant. In this case, it's necessary to wait on placement and focus on improving the bone health and quantity, beginning when we remove the old tooth and place a bone graft.

After completing the extraction, we typically place a bone graft in the empty socket. The graft will become a “scaffold” for new bone cells to grow upon. We may then allow about two to four months for new bone to partially replenish the area and then place the implant. The bone will continue to regenerate as it grows and attaches to the titanium implant to create a solid attachment.

If the site, however, still appears fragile even after partial bone growth, we may opt to wait another two to four months before attempting placement. From a long-term perspective, this is the best scenario for ensuring a durable foundation for the implant. It also allows for a socket severely compromised by disease to heal more thoroughly.

To determine which of these placement scenarios is best for you, we'll first need to conduct a thorough dental examination. From there we'll be in a better position to discuss the right implant timeline for your situation. Our main goal is to ensure we can securely place your implant in just the right position to achieve the most successful and attractive result.

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 “Implant Timelines for Replacing Missing Teeth.”