If your child has a toothache, there’s good news — and not so good news. The good news is the pain rarely indicates an emergency. On the downside, though, it may definitely be something that needs our attention.
Here, then, are 4 things you should do as a parent when your child tells you their tooth hurts.
Try to find out exactly where the pain is and how long it has hurt. Ask your child which tooth or part of the mouth hurts. You should also find out, as best you can, when the pain started and if it’s constant or intermittent. Anything you learn will be useful information if you bring them to the office for an examination. And, any tooth pain that keeps your child up at night or lasts more than a day should be examined.
Look for signs of recent injury. Your child may have suffered a blow to the mouth that has damaged the teeth and gums. Besides asking if they remember getting hurt in the mouth, be sure to look for chipped teeth, cracks or other signs of trauma. Even if there aren’t any outward signs of injury, the tooth’s interior pulp may have been damaged and should be checked out.
Look for signs of dental disease. Take a close look at the tooth your child’s complaining about: do you see brown spots or obvious cavities? You should also look for swollen gums or sores on the inside of the mouth. If there’s been no apparent injury, these could be signs of infection related to tooth decay.
Try to relieve pain symptoms. If you don’t see anything unusual, there may be a piece of candy or other hard food debris between the teeth causing the pain — gently floss around the tooth to dislodge it. If the pain persists give appropriate doses of ibuprofen or acetaminophen (not aspirin). If there’s swelling, you can also apply an icepack on the outside of the jaw. In any case, you should definitely schedule a visit with us for an examination.
If you would like more information on dental care for your child, 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 “A Child’s Toothache.”
Are you interested in dental implants but a little hesitant about the surgery? Don’t be—this procedure to imbed an implant’s titanium post in the jawbone is relatively minor with little to no discomfort for most patients.
Some time before, however, we’ll need to pre-plan the surgery to pinpoint the best location for the implant, critical to achieving a solid hold and a life-like appearance. During these first visits we often create a surgical guide, a device inserted in the mouth during surgery that identifies the exact location for the hole (or channel) in the bone we’ll drill to insert the implant.
On surgery day, we’ll prepare you for a pain-free and relaxing experience. If you’re normally anxious about dental work, we may prescribe a sedative for you to take ahead of time. As we begin we’ll thoroughly numb the area with local anesthesia to ensure you won’t feel any pain.
The surgery begins with an incision through the gum tissue to access the underlying bone. Once it’s exposed, we’ll insert the surgical guide and begin a drilling sequence to gradually increase the size of the channel. This takes time because we want to avoid damaging the bone from overheating caused by friction.
Once we’ve created a channel that matches precisely the implant’s size and shape, we’ll remove the implant from its sterile packaging and immediately fit and secure it in the channel. We’ll then take x-rays to ensure it’s in the best position possible.
Satisfied we’ve properly situated and secured the implant, we’ll suture the gum tissue back in place to protect the implant with or without attaching a healing abutment to it as it fully integrates with the jawbone over the next few months (after which you’ll come back to receive your permanent crown). After a short recovery, you’ll return to full activity. Most patients only experience mild to moderate discomfort usually manageable with over-the-counter pain medication like aspirin or ibuprofen.
While implantation is a long process, you’ll be obtaining what’s considered by most dentists and their patients as the most durable and life-like tooth replacement available. Your new attractive smile will be well worth it.
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 “Dental Implant Surgery: What to Expect Before, During and After.”
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
Not long ago the dental bridge was the alternative treatment of choice to partial dentures for restoring lost teeth. Over the last few decades, however, dental implants have nudged bridgework out of this premier spot.
That doesn’t mean, though, that bridgework has gone the way of the horse and buggy. In fact, it may still be a solid restorative alternative to partial dentures for certain people.
A traditional bridge consists of a series of porcelain crowns affixed to each other like pickets in a fence. The end crowns are fitted onto the teeth on either side of the empty tooth space; known as abutment teeth, they support the bridge. The crowns in the middle, known as pontics (from the French for “bridge”), replace the teeth that have been lost.
Bridges have been an effective and cosmetically pleasing method for tooth replacement for nearly a century. To achieve those results, though, a good portion of the abutment teeth’s structure must be removed to accommodate the crowns. This permanently alters these teeth, so they’ll require a restoration from that point on.
Dental implants, on the other hand, can be installed in the missing space without impacting any neighboring teeth. What’s more, implants provide greater support to the underlying bone than can be achieved with bridgework.
But not everyone is a viable candidate for implants, and ironically the reason most often has to do with the bone. If a patient has suffered significant bone volume loss, either because of disease or the long-term absence of the natural teeth, there may not be enough bone to properly support an implant. Unless we can adequately restore this lost bone volume through grafting, we’ll need to consider another type of restoration.
That’s where bridgework could be a viable option for patients in this or similar situations. With continuing advances in materials and new applications, the traditional bridge still remains an effective and important means to restore a smile marred by missing teeth.
If you would like more information on dental restoration options, 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 “Crowns & Bridgework.”
You may be able to slow the aging process with healthy habits but you can’t stop it. Every part of your body will change, including your teeth and gums. And even with great dental hygiene and care, there are at least two aging outcomes you may not be able to avoid: discoloration and tooth wear.
Fortunately though, we have ways to counteract these effects and help you enjoy a much younger-looking smile. These techniques range in complexity and cost, but when tailored to your individual situation they can make a world of difference and restore your confidence in your smile.
Brightening teeth that have yellowed with age can be as simple as undergoing teeth whitening. The bleaching solution in this procedure (performed in the office or at home with a prescribed kit) can minimize enamel staining built up over the years. It can even be performed with some control over the level of desired brightness. Although whitening isn’t permanent, with proper care and regular touch-ups you can keep your youthful, dazzling smile for some time.
Tooth whitening, however, may not be enough in some cases of discoloration. If so, you can gain a bright new smile with porcelain veneers or crowns. A veneer is a thin layer of tooth-colored material bonded to the front of a tooth; a porcelain crown completely covers a tooth and is usually cemented onto it.
Normal tooth wearing can also affect the appearance of older teeth, making them look shorter and with less rounded edges than younger teeth. Veneers and crowns can be utilized for this problem too, as well as enamel shaping with a dental drill to minimize those sharp edges and project a softer, younger appearance. In extreme cases, surgically reshaping the gums can give teeth a longer and a more natural look.
These are just a few of the ways we can address these two aging problems, as well as others like receding gums. Depending on your situation, it’s quite possible we can help you take years off your smile.
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