Physical pain is unpleasant—but not knowing why you're hurting makes it worse. Thousands of people encounter such as experience when parts of their face suddenly and mysteriously erupt in pain.
Often, though, the mystery can be quickly solved—more than likely, it's a nerve disorder known as trigeminal neuralgia (TN). Typically seen in people over 50 (and in more women than men), TN is a chronic condition that produces brief episodes of acute, spasmodic pain.
The source of this pain is the trigeminal nerve, which courses down each side of the face. Each nerve consists of three distinct branches that serve the upper, middle and lower areas of the face and jaw.
Physicians usually find that a blood vessel has come in contact with the nerve at some point, and the resulting pressure has damaged the nerve's outer insulative layer (myelin sheath). This causes the nerve to become hypersensitive at the point of contact, overreacting in a sense to the slightest touch (even a wisp of wind) on the face and jaw.
TN isn't the only source of facial pain. It can also accompany other conditions like TMD, which is why it's important to undergo a diagnostic examination. If you are diagnosed with TN, there are a number of ways to manage it. The most conservative approach (and the one usually tried first) is the use of medications to block pain signals from the nerve to the brain or to lessen abnormal nerve firing.
If medication proves ineffective or there are other factors related to age and health, you may be a candidate for a surgical solution. In one such procedure, a surgeon inserts a thin needle into the affected nerve and selectively damages some of its fibers to prevent the transmission of pain signals. Another procedure relocates the impinging blood vessel, which then allows the nerve to heal.
These surgical methods are effective but they can cause side-effects in rare cases like numbness or hearing impairment. It's best then to discuss with your doctor which approach would be best for you and your life situation. Ultimately, though, there are ways to relieve you of this painful condition.
If you would like more information on treating facial pain, 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.”
Although kids are resilient, they're not indestructible. They're prone to their share of injuries, both major and minor—including dental injuries.
It's common for physically active children to suffer injuries to their mouth, teeth and gums. With a little know-how, however, you can reduce their suffering and minimize any consequences to their long-term oral health.
Here are 4 types of dental injuries, and what to do if they occur.
Chipped tooth. Trauma or simply biting down on something hard can result in part of the tooth breaking off, while the rest of it remains intact. If this happens, try to retrieve and save the chipped pieces—a dentist may be able to re-bond them to the tooth. Even if you can't collect the chipped pieces, you should still see your dentist for a full examination of the tooth for any underlying injury.
Cracked tooth. A child can experience intense pain or an inability to bite or close their teeth normally if a tooth is cracked (fractured), First, call the dentist to see if you need to come in immediately or wait a day. You can also give the child something appropriate to their age for pain and to help them sleep if you're advised to wait overnight.
Displaced tooth. If a child's tooth appears loose, out of place or pushed deeper into the jaw after an accident, you should definitely see a dentist as soon as possible—all of these indicate a serious dental injury. If they're unavailable or it's after hours, your dentist may tell you to visit an emergency room for initial treatment.
Knocked-out tooth. Minutes count when a tooth is knocked completely out. Quickly locate the tooth and, holding it only by the crown and not the root, rinse off any debris with clean water. Place it in a glass of milk or attempt to place it back into the socket. If you attempt to place it back into the socket, it will require pressure to seat the tooth into position. You should then see a dentist or ER immediately.
A dental injury can be stressful for both you and your child. But following these common-sense guidelines can help you keep your wits and ensure your child gets the care they need.
The NBA's reigning MVP Giannis Antetokounmpo may seem unstoppable, but he proved no match for a troubled tooth. Antetokounmpo, the self-proclaimed “Greek Freak,” missed one of the final three 2020 regular season games for a dental issue that resulted in last-minute oral surgery. According to a Milwaukee Bucks spokesperson, the star underwent “a root-canal like procedure.”
Root canal therapy, often simply called “a root canal,” may be needed when there is an infection inside the tooth. When dental pulp becomes inflamed or infected, excruciating pain can result. Pulp is the soft tissue that fills the inside of the tooth. It is made up of nerves, blood vessels and connective tissue. During root canal treatment, the pulp is removed, the space inside the tooth is disinfected, it is filled with a special material, and then the hole is sealed up.
A root canal is nothing to fear. It relieves pain by getting rid of infection and is so effective that over 15 million of them are performed in the U.S. each year. This routine procedure generally requires only local anesthetic, and your mouth should be back to normal within a day or two after treatment. Antetokounmpo can attest to that, as he returned to play the next day.
However, delaying root canal treatment when you need it can have serious consequences. If left untreated, an infection inside the tooth continues to spread, and it may move into the gums and jaw and cause other problems in the body. So, how do you know if you may need a root canal? Here are some signs:
Lingering sensitivity to hot or cold temperatures. One sign of nerve damage inside your tooth is pain that is still there 30 seconds after eating or drinking something hot or cold.
Intense pain when biting down. You may feel pain deep within your tooth, or in your jaw, face or other teeth. The pain may be hard to pinpoint—and even if it improves at times, it usually comes back.
A chipped, cracked or discolored tooth. A chip or crack can allow bacteria to enter the tooth, and the tooth may darken if the tissue inside is damaged.
A pimple on the gum. A bump or pimple on the gum that doesn't go away or keeps coming back may signify that a nearby tooth is infected.
Tender, swollen gums. Swollen gums may indicate an infection inside the tooth or the need for periodontal treatment.
And sometimes there is no pain, but an infection may be discovered during a dental exam.
Tooth pain should never be ignored, so don't put off a dental visit when you have a toothache. In fact, if a bad toothache goes away, it could mean that the nerves inside the tooth have died, but the infection may still be raging. Also, be sure to keep up with your regular dental checkups. We may spot a small problem that can be addressed before it becomes a bigger problem that would require more extensive treatment.
Remember, for dental issues both large and small, we're on your team! If you would like more information about tooth pain, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Tooth Pain? Don't Wait!” and “Root Canal Treatment: What You Need to Know.”
While mouth pain can certainly get your attention, what exactly hurts may be difficult to identify. It might seem to emanate from a single tooth, or a group of teeth. Then again, it might not be clear whether it's coming from teeth or from the gums.
Still, it's important to pinpoint the cause as much as possible to treat it correctly. One of the main questions we often want to answer is whether the cause originates from within a tooth or without.
In the first case, tooth decay may have entered the pulp at the center of the tooth. The pulp contains nerve bundles that can come under attack from decay and transmit pain signals. Incidentally, if the pain suddenly goes away, it may simply mean the nerves have died and not the infection.
The decay can also spread into the root canals leading to the root and supporting bone, and then make the jump into the gum tissues. One possible sign of this is the one mentioned earlier—you can't quite tell if the pain is from the tooth or the surrounding gums.
The root canals could also serve as a transportation medium for infection in the other direction. In that case, gum disease has advanced into the bone tissues around a tooth near its roots. The infection can then cross into the tooth. Again, both a tooth and the gum tissue around it can become diseased.
We have effective treatments for individual occurrences of interior tooth decay or gum disease: The former usually requires a root canal treatment to remove infected tissue and fill and seal the tooth from future infection; we alleviate gum disease by removing the dental plaque causing it and helping the gum tissues to heal. But combined tooth and gum infection scenarios are more difficult to treat, have a poorer prognosis and may require specialists.
To reduce the risk of either tooth decay or gum disease developing into this greater problem, it's best to take action at the first sign of trouble. So, see your dentist as soon as possible when you encounter oral pain or if you notice swollen or bleeding gums. The earlier we treat the initial outbreak of disease, be it tooth decay or gum disease, the better your chances of a successful and happy outcome.
If you would like more information on tooth pain, 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 “Confusing Tooth Pain.”
It gradually dawned on our ancient ancestors that a healthy mouth was usually a clean one. To achieve that blessed oral state, they chewed on tree bark or employed primitive toothbrushes like bamboo sticks with hog hair bristles attached to their ends.
Today, we have better tools and methods for achieving a cleaner and healthier mouth. But these advancements do little good if a) we don't use them on a daily basis, and b) we're not proficient with them.
October is National Dental Hygiene Month, highlighting once again the importance of these two points for keeping teeth and gums as clean as possible. First and foremost, oral hygiene should never take a holiday—even a day or two of accumulated plaque, the bacterial biofilm that builds up on teeth surfaces, can trigger the occurrence of gum disease or tooth decay.
But while "showing up" every day to brush and floss goes a long way toward a healthy mouth, you also need to perform these tasks well. An inadequate job can leave residual plaque that could still cause disease.
Here are a few handy tips to improve your oral hygiene routine.
Do a thorough job. Plaque can be stubborn, clinging to the nooks and crannies of teeth and around the gum lines—and it can easily be missed while brushing. Be sure, then, to thoroughly work your toothbrush's bristles into all dental surfaces. Your efforts should take about 2 minutes to complete.
Don't be too aggressive. You may need "elbow grease" to clean your floors, but not your teeth. Too much pressure applied while brushing can damage enamel and gums. Instead, go easy when you brush and let the toothpaste's mild abrasives do the heavy lifting.
Use flossing tools. Many people avoid flossing because they find it too hard or cumbersome with traditional flossing thread. If this is a problem for you, consider using a flossing tool—a floss threader or pick, or even a water flosser appliance that uses pressurized water to break up and remove plaque.
Take the "tongue test." Wondering how well you're doing with your hygiene efforts? One quick way to find out is the "tongue test": Simply swipe your tongue across your teeth just after brushing and flossing. If they feel gritty rather than smooth, you may have left some plaque behind.
Besides your personal hygiene efforts, be sure you also have your teeth cleaned regularly by a dental hygienist to rid your mouth of any residual plaque and tartar (hardened plaque)—these can also cause dental disease. Professional care coupled with proficient daily hygiene will help ensure you have cleaner mouth and better dental health.
If you would like more information on the best ways to incorporate oral hygiene into your life, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Daily Oral Hygiene.”
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