Posts for category: Oral Health
A toothache means a tooth has a problem, right? Most of the time, yes: the pain comes from a decayed or fractured tooth, or possibly a gum infection causing tooth sensitivity.
Sometimes, though, the pain doesn't originate with your teeth and gums. They're fine and healthy—it's something outside of your tooth causing the pain. We call this referred pain—one part of your body is sending or referring pain to another part, in this instance around your mouth.
There are various conditions that can create referred pain in the mouth, and various ways to treat them. That's why you should first find out the cause, which will indicate what treatment course to take.
Here are a few common non-dental causes for tooth pain.
Trigeminal Neuralgia. The trigeminal nerves situated on either side of the face have three large branches that extend throughout the face; the branch to the jaw allows you to feel sensation as you chew. When one of the nerve branches becomes inflamed, usually from a blood vessel or muscle spasm pressing on it, it can refer the pain to the jaw and seem like a toothache.
Temporomandibular Joint Disorder (TMD). These two joints that connect the lower jaw to the skull can sometimes become dysfunctional for a variety of reasons. This can set up a cycle of spasms and pain that can radiate throughout the jaw and its associated muscles. The pain can mimic a toothache, when it actually originates in the jaw joints.
Teeth Grinding. This is an unconscious habit, often occurring at night, in which people clench or grind their teeth together. Although quite common in children who tend to grow out of it, teeth grinding can continue into adulthood. The abnormally high biting forces from this habit can cause chipped, broken or loosened teeth. But it can also cause jaw pain, headaches and tenderness in the mouth that might feel like a toothache.
These and other conditions unrelated to dental disease can seem like a tooth problem, when they're actually something else. By understanding exactly why you're feeling pain, we can then focus on the true problem to bring relief to your life.
Drugs play an indispensable role in treating disease. For example, life without antibiotics would be much more precarious—common infections we think nothing of now would suddenly become life-threatening.
But even the most beneficial drug can have disruptive side effects. Antibiotics in particular can cause a rare but still disturbing one: a growth on the tongue that at first glance looks like dark hair. In fact, it's often called "black hairy tongue."
It isn't hair—it's an overgrowth of naturally occurring structures on the tongue called filiform papillae. These tiny bumps on the tongue's upper surface help grip food while you're chewing. They're normally about a millimeter in length and tend to be scraped down in the normal course of eating. As they're constantly growing, they replenish quickly.
We're not sure how it occurs, but it seems with a small portion of the population the normal growth patterns of the papillae become unbalanced after taking antibiotics, particularly those in the tetracycline family. Smoking and poor oral hygiene also seem to contribute to this growth imbalance. As a result, the papillae can grow as long as 18 millimeters with thin shafts resembling hair. It's also common for food debris and bacteria to adhere to this mass and discolor it in shades of yellow, green, brown or black.
While it's appearance can be bizarre or even frightening, it's not health-threatening. It's mostly remedied by removing the original cause, such as changing to a different antibiotic or quitting smoking, and gently cleaning the tongue everyday by brushing it or using a tongue scraper you can obtain from a pharmacy.
One word of caution: don't stop any medication you suspect of a side effect without first discussing it with your prescribing doctor. While effects like black hairy tongue are unpleasant, they're not harmful—and you don't want to interfere with treatments for problems that truly are.
You may think your blood pressure is only important to your general health — but it can also affect your dental care. That’s why it’s increasingly common for dental providers to include blood pressure monitoring for patients during routine visits.
High blood pressure is a risk factor for several major health conditions including heart attack, stroke and diabetes, and is one of the most common diagnoses in the United States. Even so, many people don’t know their blood pressure is abnormally high. It may be discovered during an annual health visit, or not at all. Since many people visit their dentist twice a year for cleanings, taking a blood pressure reading during these visits increases the chance of detecting a high pressure.
In one study published in the Journal of the American Dental Association, the researchers looked at dental patients who had not seen a doctor in the previous twelve months and who underwent blood pressure screening during a regular dental visit. Seventeen percent of those studied learned they were at increased risk for cardiovascular disease.
High blood pressure can also have a direct effect on how we treat your teeth and gums. For example, we may have to adapt and become more diligent about preventing dental disease if you’re taking a blood pressure drug that could trigger reduced saliva flow (dry mouth), a factor in tooth decay. Certain local anesthetics may also contain substances like epinephrine that constrict blood vessels, which can increase blood pressure. To avoid this if you’re hypertensive, we may need to adjust the dosage of anesthetic drugs to lessen this effect.
Monitoring blood pressure in the dental office is a good example of how all healthcare services can interact with each other. At the very least, a blood pressure check at your next cleaning could alert you to a potentially dangerous condition you didn’t even know you had.
If you would like more information on the relationship of blood pressure and other medical issues to dental health, 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 “Monitoring Blood Pressure.”
Aspirin has been a popular pain reliever and fever reducer for over a century. Its effect on the clotting mechanism of blood, however, has led to its widespread and often daily use in low dose form (81 mg) to help reduce the chances of heart attack or stroke in cardiovascular patients. While this has proven effective for many at risk for these conditions, it can complicate dental work.
Aspirin relieves pain by blocking the formation of prostaglandins; these chemicals stimulate inflammation, the body’s protective response to trauma or disease. Aspirin reduces this inflammatory response, which in turn eases the pain and reduces fever. It also causes blood platelets to stop them from clumping together. This inhibits clotting, which for healthy individuals could result in abnormal bleeding but is beneficial to those at risk for heart attack or stroke by keeping blood moving freely through narrowed or damaged blood vessels.
Even for individuals who benefit from regular aspirin therapy there are still risks for unwanted bleeding. Besides the danger it may pose during serious trauma or bleeding in the brain that could lead to a stroke, it can also complicate invasive medical procedures, including many in dentistry. For example, aspirin therapy could increase the rate and degree of bleeding during tooth extraction, root canal or other procedures that break the surface of soft tissue.
Bleeding gums after brushing is most often a sign of periodontal (gum) disease. But if you’re on an aspirin regimen, gum bleeding could be a side effect. A thorough dental examination will be necessary to determine whether your medication or gum disease is the root cause.
It’s important, then, to let us know if you’re regularly taking aspirin, including how often and at what dosage. This will help us make more accurate diagnoses of conditions in your mouth, and will enable us to take extra precautions for bleeding during any dental procedures you may undergo.
If you would like more information on the effects of aspirin and similar medications on dental treatment, 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 “Aspirin: Friend or Foe?”
Whatever problems you may have with your teeth and gums, there are effective solutions in modern dentistry. But like other aspects of healthcare, dental treatment can be quite costly. For many it isn't what can be done but what they can afford to have done.
If you too have limited financial means, don't lose hope — there are effective ways to manage your dental care, especially with a little planning ahead.
The most important thing you can do to manage dental costs is to prevent disease through consistent oral hygiene — brushing and flossing — at least once a day. Removing bacterial plaque, a film of leftover food particles that can trigger infection, from your teeth will significantly lower your risk of tooth decay and periodontal (gum) disease, two very common sources of dental care costs.
It's also important that you visit the dentist at least twice a year. Although it's an expense, it's worth budgeting because it could, along with daily hygiene, save you money in the future. During these visits we'll remove plaque and calculus (hardened plaque deposits) from hard to reach places you might have missed. We'll also check for developing problems: the earlier they're detected the less the long-term impact on your finances.
We'll also evaluate your individual risk factors for dental disease. Some, like hereditary factors, we can't control. But others, like diet and lifestyle choices, we can alter to significantly lower your chance of disease.
With this risk factor profile, we can then put together an ongoing treatment strategy. Not only will this help prevent or at least reduce problems with your teeth and gums, it will help reduce costs in the long run.
Unfortunately, even with the best efforts we can't altogether rule out problems. We'll need to treat those that arise, and usually the sooner the better. Even so, we can usually take your financial situation into account, such as a less expensive temporary measure until you can afford a more permanent solution. We also have payment programs that can help you manage costs as well.
The important thing is not to delay regular dental checkups. The sooner you begin quality dental care the less of an impact any problems we find will pose to your dental health and your wallet.
If you would like more information on financial management for your dental care, 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 “Cost-Saving Treatment Alternatives.”