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.”
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.”
Nina Parker, the host of Love & Hip Hop for six seasons, is now busy with the new game show Blockbusters and her own talk show The Nina Parker Show. But even with a full plate, she took time recently for some personal care—getting a new smile.
Parker's fans are familiar with her noticeable tooth gap. But a video on TikTok in February changed all that: In the video, she teasingly pulls away a mask she's wearing to reveal her smile—without the gap.
Parker and other celebrities like Madonna, Michael Strahan and David Letterman are not alone. Teeth gaps are a common smile feature, dating back millennia (even in fiction: Chaucer described the Wife of Bath as being "gap-toothed" in The Canterbury Tales).
So, what causes a tooth gap? Actually, a lot of possibilities. The muscle between the teeth (the frenum) may be overly large and pushing the teeth apart. There may be too much room on the jaw, so the teeth spread apart as they develop. It might also have resulted from tongue thrusting or late thumb sucking as a child, influencing the front teeth to develop forward and outward.
A tooth gap can be embarrassing because they're often front and center for all the world to see, but they can also cause oral health problems like complicating oral hygiene and increasing your risk for tooth decay. They can also contribute to misalignment of other teeth.
Fortunately, there are ways to alleviate a gap. One way is to move the teeth closer together with either braces or removable clear aligners. This may be the best approach if the gap is wide and it's contributing to misalignment of other teeth. You may also need surgery to alter the frenum.
You can also reduce less-pronounced gaps cosmetically with dental bonding or porcelain veneers. Bonding involves applying a type of resin material to the teeth on either side of the gap. After some sculpting to make it appear life-like, we harden the material with a curing light. The result is a durable, tooth-like appearance that closes the gap.
A veneer is a thin wafer of porcelain, custom-made to fit an individual patient's tooth. Bonded to the front of teeth, veneers mask various dental flaws like chips, deformed teeth, heavy staining and, yes, mild to moderate tooth gaps. They do require removing a small amount of enamel on the teeth they cover, but the results can be stunning—completely transformed teeth without the gap.
Getting rid of a tooth gap can be a wise move, both for your smile and your health. You may or may not take to social media to show it off like Nina Parker, but you can feel confident to show the world your new, perfect smile.
If you would like more information about treating teeth gaps and other dental flaws, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Space Between Front Teeth.”
Disasters are an unfortunate part of life—and not just on the epic scale of a hurricane, flood or earthquake. You could easily find yourself having your own "personal pizza"-sized disaster—a car accident, a sports injury or even a tumble on a leisurely hike. And oftentimes, the consequences could affect your mouth, teeth or jaws.
We can't always account for every variable in life, but we can prepare for possible disasters, big or small. That includes being ready for a possible dental injury.
September is National Preparedness Month, when safety and emergency professionals seek to raise awareness about what people can do to prepare for when disaster strikes. When it comes to protecting you and your family's oral health, here are a few things you can do to stop or lessen the impact of a dental injury.
Use a mouthguard. These soft, plastic appliances that fit in the mouth cushion the force of a hard blow to the face and jaws. They're a must for any contact sport like football or basketball, but also for other outdoor activities like trail biking. It's also worth the investment in comfort and effectiveness to have your dentist create a mouthguard customized just for you.
Create a dental first aid kit. It's a good idea to carry along a first aid kit during sports or other physical activities. It's a great idea to include a few extra items in case of injuries to the teeth or gums. A dental mirror and flashlight, medical-grade gloves, "Save a Tooth" kits (for knocked out teeth) or even tea bags to help stop bleeding gums are handy to have if you or someone with you suffers a dental-related injury.
Know what to do in case of dental injury. As careful as you might be, you can't completely eliminate the risk of dental injury, so it's wise to know how to render specific first aid for a variety of mouth-related injuries. To that end, we've provided a free dental injury field guide that you can print to review or to include in your emergency first aid kit.
Locate dental providers away from home. Serious injuries that result in loose, knocked out or misaligned teeth need immediate dental care. No problem if your regular dentist is close at hand—but what if you're out of town or on vacation? Before you go, locate a dental provider at your destination that you can see in case of emergency, and keep their contact information close at hand.
It's no fun going through an adverse event, especially with the possibility of injury. It's even worse to meet disaster unprepared. By following these guidelines, you can have a better handle on the injury risks to you and your family's dental health.
If you would like more information about protecting your teeth from injury, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “An Introduction to Sports Injuries & Dentistry.”
At what age should you begin treating a poor bite? Many might say with braces around late childhood or early adolescence. But some bite problems could be addressed earlier—with the possibility of avoiding future orthodontic treatment.
A crossbite is a good example. In a normal bite, all of the upper teeth slightly cover the lower when the jaws are shut. But a crossbite occurs when some of the lower teeth, particularly in back, overlap the upper teeth. This situation often happens when the upper jaw develops too narrowly.
But one feature of a child's mouth structure provides an opportunity to intervene and alter jaw development. During a child's early years, the palate (roof of the mouth) consists of two bones next to each other with an open seam running between them. This seam, which runs through the center of the mouth from front to back, will fuse during puberty to form one continuous palatal bone.
An orthodontist can take advantage of this separation if the jaw isn't growing wide enough with a unique device called a palatal expander. This particular oral appliance consists of four, thin metal legs connected to a central mechanism. The orthodontist places the expander against the palate and then uses the mechanism to extend the legs firmly against the back of the teeth on both sides of the jaw.
The outward pressure exerted by the legs also widens the seam between the two palatal bones. The body will respond to this by adding new bone to the existing palatal bones to fill in the widened gap. At regular intervals, the patient or a caregiver will operate the mechanism with a key that will continue to widen the gap between the bones, causing more expansion of the palatal bones until the jaw has grown to a normal width.
The palatal expander is most effective when it's applied early enough to develop more bone before the seam closes. That's why it's important for children to undergo bite evaluation with an orthodontist around age 6. If it appears a bite problem is developing, early interventions like a palatal expander could slow or stop it before it gets worse.
If you would like more information on interceptive orthodontics, 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 “Palatal Expanders.”
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