Posts for category: Oral Health
Each year doctors treat about 150,000 new cases of severe facial pain. If you're one of those people, you don't have to suffer—there are ways to gain relief from these painful episodes.
Those recurring episodes are known as trigeminal neuralgia (TN). As the name implies, the source of the pain are the trigeminal nerves, which originate in the brain stem and extend on either side of the face. Each is divided into three branches (hence the "tri" in trigeminal) that serve the upper, middle and lower parts of the face and jaw.
TN can involve one or more of these branches, resulting in mild to severe pain that can last for several seconds. Jaw movements like chewing or speaking can trigger an episode, as well as a light touch to the face.
There are various proposed causes for TN, including links with inflammatory disorders like multiple sclerosis, which damages the insulating sheathing around nerve cells. The most common cause, though, appears to be a blood vessel pressing against the nerve. The compression causes hypersensitivity in that area of the nerve so that it transmits pain at the slightest sensation.
Other conditions like jaw joint pain disorders (TMD) or a dental abscess can cause similar pain symptoms, so it's important to get an accurate diagnosis. If your doctor does identify your condition as TN, you may then need a comprehensive approach to treatment involving a team of care providers, including your dentist.
For the most part, TN can be managed, beginning with the most conservative approach to gain relief, often with medications to block the nerve's pain signals to the brain or decrease abnormal nerve firings. If that proves insufficient, though, more intensive treatments are available.
One possible treatment for an impinging blood vessel is a microsurgical procedure to expose the affected nerve and relocate the vessel. While this can be effective, the surgery does carry some risk of facial numbness or decreased hearing. If the risks are too high for conventional surgery, an alternative procedure uses a precise beam of high-dose radiation to relieve the pressure from the vessel.
The most important thing to know about TN, though, is that it is possible to control it and relieve future pain episodes. If you're experiencing these symptoms, see your dentist or doctor for an exam and accurate diagnosis.
If you would like more information on trigeminal neuralgia, 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: A Nerve Disorder that Causes Facial Pain.”
Although cancer treatment has advanced steadily in recent decades, the most used therapies continue to be radiation and chemotherapy to eradicate cancerous cells. And while they often work, both can cause "collateral damage" in healthy tissues near the targeted cells.
This can create a number of indirect consequences for a patient's health, including in the mouth. The salivary glands, for example, can be damaged by radiation treatments aimed at the head or neck. The effect on these glands can interrupt the normal flow of saliva and cause xerostomia or "dry mouth."
Lack of adequate saliva causes more than an unpleasant, sticky mouth feeling. One of saliva's main functions is to neutralize acid that builds up naturally after eating. Without it, high acid levels can cause enamel and root surface erosion and lead to tooth decay.
Cancer treatment can also contribute to gastro-esophageal reflux disease (GERD). This disease causes stomach acid to bypass the natural tissue barriers of the esophagus and enter the mouth. As with dry mouth, the increased acid level from GERD can be just as devastating to enamel—and the damage will be permanent.
To minimize these effects on your dental health, it's important to take proactive steps before, during and after cancer treatment. If at all possible, have any needed dental work performed before you begin radiation or chemotherapy—it's better to start it with teeth and gums as healthy as possible.
During treatment, try to continue regular dental visits to monitor your oral health and receive any needed preventive or therapeutic treatments. Depending on your condition and the advice of your dentist, you may need to increase your visit frequency during this time. Your dentist can help with boosting your saliva production and strengthening your tooth enamel. But you should also practice daily brushing and flossing, drink plenty of water and seek treatment for any resulting GERD symptoms.
Even with the best efforts, though, your teeth and gums may still incur damage while treating your cancer. Fortunately, there are a wide array of materials and procedures that can effectively restore them to health. So, once your treatments are completed consult with a dentist on your options for improving the health and appearance of your teeth and gums.
Singer and actor Demi Lovato has a new claim to fame: formidable martial artist. When she is not in the recording studio, on stage or in front of the camera, Lovato can often be found keeping in shape at Jay Glazer's Hollywood (California) gym. Glazer, who is best known as a sports journalist, also runs conditioning programs for professional athletes and celebrities based on mixed martial arts. On March 6, Glazer got more than he bargained for when 5'3" Lovato stepped into the ring and knocked out his front tooth.
Glazer reportedly used super glue to put his tooth back together. Not a good idea! While it may not be convenient to drop everything and get to the dental office, it takes an expert to safely treat a damaged tooth. If you glue a broken tooth, you risk having to undergo major work to correct your temporary fix—it's no easy task to "unglue" a tooth, and the chemicals in the glue may damage living tooth tissue as well as the surrounding gum and bone.
Would you know what to do in a dental emergency? Here are some guidelines:
- If you chip a tooth, save the missing piece if possible. We may be able to reattach it.
- If your tooth is cracked, rinse your mouth with warm water, but don't wiggle the tooth around or bite down on it. If it's bleeding, hold clean gauze to the area and call our office.
- If your tooth is knocked loose or is pushed deeper into the socket, don't force the tooth back into position on your own. Immediate attention is very important.
- If your tooth is knocked out, there's a chance it can be reattached. Pick up the tooth while being careful not to touch the root. Then rinse it off and have either someone place into its socket, or place it against the inside of your cheek or in a glass of milk. Please call the office immediately or go to a hospital.
What's the best thing to do in an emergency? Call us right away, and DON'T super glue your tooth! You can prevent worse problems by letting a professional handle any dental issues. And if you've been living with a chipped, broken or missing tooth, call us to schedule an appointment for a consultation—there are several perfectly safe ways to restore your smile. Meanwhile, if you practice martial arts to keep in shape, think twice before getting into the ring with Demi Lovato!
Every May, the National Fibromyalgia & Chronic Pain Association asks people around the world to spread awareness of fibromyalgia and other chronic pain conditions. Anyone with fibromyalgia and its associated joint and muscle pain knows all too well how chronic pain can disrupt everyday life. And as we see frequently in the dental office, people contending with the jaw pain and dysfunction associated with a temporomandibular joint disorder (TMD) can equally relate.
But here’s the kicker—if you’ve been diagnosed with either TMD or fibromyalgia, there’s a good chance you’re also dealing with both conditions. For example, in one recent survey of over a thousand TMD patients, two-thirds reported also having fibromyalgia or similar kinds of health issues. Researchers are looking intently at possible connections between TMD and fibromyalgia since understanding any potential link between the two might open the door to new ways of treatment.
Fibromyalgia patients experience frequent muscle spasms and fatigue throughout their bodies, coupled with other problems like sleeplessness and memory difficulties. Most researchers today believe it’s caused by a malfunction within the central nervous system (CNS) to process pain. Those working with TMD research are also considering whether the same type of malfunction contributes to jaw joint pain and dysfunction.
TMD is an umbrella term for various disorders involving the jaw joints and associated muscles. When you come to the dental office, it is important that we know about any TMD pain you may be experiencing because this can affect your dental visits. For example, people with TMD may have trouble holding their mouth open for an extended period of time, so we can adjust dental exams and treatments accordingly. Also, we will want to look for underlying dental conditions that may have contributed to your TMD.
If you’re experiencing both TMD and fibromyalgia symptoms, be sure you let us as well as your rheumatologist know the various symptoms you’re experiencing with each condition, the treatments you’re undergoing and the medications you’re taking.
For TMD in particular, here are a few things you can do to reduce its impact on your daily life:
- Avoid foods that require heavy chewing or jaw widening;
- Use thermal therapies like warm compresses or ice packs to ease jaw stiffness and pain;
- Practice relaxation techniques to reduce stress in your life;
- Ask about muscle relaxants or other medications that might help.
You may find that some of these practices, particularly stress reduction, are also helpful in managing fibromyalgia. And if there is a deeper connection between TMD and fibromyalgia, unraveling the mystery could hopefully lead to even greater relief for both.
If you would like more information about managing your symptoms, please contact us or schedule an appointment for a consultation. To learn more, read the Dear Doctor magazine articles “Chronic Jaw Pain and Associated Conditions” and “Fibromyalgia and Temporomandibular Disorders.”
Periodontal (gum) disease can weaken gum attachment and cause bone deterioration that eventually leads to tooth loss. But its detrimental effects can also extend beyond the mouth and worsen other health problems like heart disease or diabetes.
While the relationship between gum disease and other health conditions isn't fully understood, there does seem to be a common denominator: chronic inflammation. Inflammation is a natural defense mechanism the body uses to isolate damaged or diseased tissues from healthier ones. But if the infection and inflammation become locked in constant battle, often the case with gum disease, then the now chronic inflammation can actually damage tissue.
Inflammation is also a key factor in conditions like heart disease and diabetes, as well as rheumatoid arthritis or osteoporosis. Inflammation contributes to plaque buildup in blood vessels that impedes circulation and endangers the heart. Diabetes-related inflammation can contribute to slower wound healing and blindness.
Advanced gum disease can stimulate the body's overall inflammatory response. Furthermore, the breakdown of gum tissues makes it easier for bacteria and other toxins from the mouth to enter the bloodstream and spread throughout the body to trigger further inflammation. These reactions could make it more difficult to control any inflammatory condition like diabetes or heart disease, or increase your risk for developing one.
To minimize this outcome, you should see a dentist as soon as possible if you notice reddened, swollen or bleeding gums. The sooner you begin treatment, the less impact it may have on your overall health. And because gum disease can be hard to notice in its early stages, be sure you visit the dentist regularly for cleanings and checkups.
The most important thing you can do, though, is to try to prevent gum disease from occurring in the first place. You can do this by brushing twice and flossing once every day to keep dental plaque, the main trigger for gum disease, from accumulating on tooth surfaces.
Guarding against gum disease will certainly help you maintain healthy teeth and gums. But it could also help protect you from—or lessen the severity of—other serious health conditions.
If you would like more information on preventing and treating gum disease, 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 “Good Oral Health Leads to Better Health Overall.”
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