If you're one of over 30% of Americans who wince in pain when eating and drinking certain foods and beverages, you may have tooth sensitivity. Although there are a number of possible causes, the most common place to look first is tooth dentin.
Lying just under the enamel, dentin consists of tiny tubules that transmit sensations like pressure or temperature variation to the nerves of the inner pulp. The enamel, the gums and a covering on the roots called cementum help dampen these sensations.
But over-aggressive brushing or periodontal (gum) disease can cause the gums to shrink back (recede) and expose the dentin below the gum line; it can also cause cementum to erode from the roots. This exposure amplifies sensations to the nerves. Now when you eat or drink something hot or cold or simply bite down, the nerves inside the dentin receive the full brunt of the sensation and signal pain.
Enamel erosion can also expose dentin, caused by mouth acid in contact with the enamel for prolonged periods. Acid softens the minerals in enamel, which then dissolve (resorb) into the body. Acid is a byproduct of bacteria which live in dental plaque, a thin film of food particles that builds up on teeth due to poor oral hygiene. Mouth acid may also increase from gastric reflux or consuming acidic foods or beverages.
Once we pinpoint the cause of your tooth sensitivity we can begin proper treatment, first and foremost for any disease that's a factor. If you have gum disease, we focus on removing bacterial plaque (the cause for the infection) from all tooth and gum surfaces. This helps stop gum recession, but advanced cases may require grafting surgery to cover the root surfaces.
You may also benefit from other measures to reduce sensitivity:Â applying less pressure when you brush; using hygiene products like toothpastes that block sensations to the dentin tubules or slow nerve action; and receiving additional fluoride to strengthen enamel.
There are effective ways to reduce your tooth sensitivity. Determining which to use in your case will depend on the cause.
If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity: Understanding Your Options.”
Periodontal (gum) disease is mainly caused by bacterial plaque built up on tooth surfaces due to ineffective oral hygiene. For most cases, treatment that includes plaque and calculus (tartar or calcified plaque) removal and renewed daily hygiene is highly effective in stopping the disease and restoring health to affected gum tissues.
However, you might have additional health factors that may make it more difficult to bring the disease under control. If your case is extreme, even the most in-depth treatment may only buy time before some or all of your teeth are eventually lost.
Genetics. Because of your genetic makeup, you could have a low resistance to gum disease and are more susceptible to it than other people. Additionally, if you have thin gum tissues, also an inherited trait, you could be more prone to receding gums as a result of gum disease.
Certain bacteria. Our mouths are home to millions of bacteria derived from hundreds of strains, of which only a few are responsible for gum disease. It’s possible your body’s immune system may find it difficult to control a particular disease-causing strain, regardless of your diligence in oral care.
Stress. Chronic stress, brought on by difficult life situations or experiences, can have a harmful effect on your body’s immune system and cause you to be more susceptible to gum disease. Studies have shown that as stress levels increase the breakdown of gum tissues (along with their detachment from teeth) may also increase.
Disease advancement. Gum disease can be an aggressive infection that can gain a foothold well before diagnosis. It’s possible, then, that by the time we begin intervention the disease has already caused a great deal of damage. While we may be able to repair much of it, it’s possible some teeth may not be salvageable.
While you can’t change genetic makeup or bacterial sensitivity, you can slow the disease progression and extend the life of your teeth with consistent daily hygiene, regular cleanings and checkups, and watching for bleeding, swollen gums and other signs of disease. Although these additional risk factors may make it difficult to save your teeth in the long-run, you may be able to gain enough time to prepare emotionally and financially for dental implants or a similar restoration.
If you would like more information on the treatment of 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 “Periodontal (Gum) Treatment & Expectations.”
Can you have healthy teeth and still have gum disease? Absolutely! And if you don’t believe us, just ask actor David Ramsey. The cast member of TV hits such as Dexter and Arrow said in a recent interview that up to the present day, he has never had a single cavity. Yet at a routine dental visit during his college years, Ramsey’s dentist pointed out how easily his gums bled during the exam. This was an early sign of periodontal (gum) disease, the dentist told him.
“I learned that just because you don’t have cavities, doesn’t mean you don’t have periodontal disease,” Ramsey said.
Apparently, Ramsey had always been very conscientious about brushing his teeth but he never flossed them.
“This isn’t just some strange phenomenon that exists just in my house — a lot of people who brush don’t really floss,” he noted.
Unfortunately, that’s true — and we’d certainly like to change it. So why is flossing so important?
Oral diseases such as tooth decay and periodontal disease often start when dental plaque, a bacteria-laden film that collects on teeth, is allowed to build up. These sticky deposits can harden into a substance called tartar or calculus, which is irritating to the gums and must be removed during a professional teeth cleaning.
Brushing teeth is one way to remove soft plaque, but it is not effective at reaching bacteria or food debris between teeth. That’s where flossing comes in. Floss can fit into spaces that your toothbrush never reaches. In fact, if you don’t floss, you’re leaving about a thirdÂ to half of your tooth surfaces unclean — and, as David Ramsey found out, that’s a path to periodontal disease.
Since then, however, Ramsey has become a meticulous flosser, and he proudly notes that the long-ago dental appointment “was the last we heard of any type of gum disease.”
Let that be the same for you! Just remember to brush and floss, eat a good diet low in sugar, and come in to the dental office for regular professional cleanings.
If you would like more information on flossing or periodontal disease, please contact us today to schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Understanding Gum (Periodontal) Disease.”
You might see your teeth and gums as separate parts of your mouth. But we dentists see them as a unified biological system, each of them contributing to your mouth's various functions: eating, speaking and, of course, smiling.
The teeth-gum-mouth relationship is also a factor when things aren't going well. Tooth decay, for example, doesn't suddenly appear — conditions have to be present in the mouth to cause it. The same can be said for periodontal (gum) disease or bite problems.
So the best approach in dental care is to consider the whole — to first learn all we can about your mouth. We need to understand not only your current problems but also your health history and the unique features of your mouth. With this deeper understanding we can formulate a long-term plan that addresses all your individual needs.
We specifically want to identify your individual oral health risks, from your genetic makeup to any past problems with dental disease or the bite. We then want to assess your current state of health: do you have any presence of dental disease? Is any past dental work failing or in need of updating? Are there any biomechanical issues with the bite or bone loss that need to be addressed?
With this more complete picture, we can then prioritize your care and treatment. Some things like gum disease require immediate attention. Other areas such as bite problems or cosmetic issues may require planning and time to fully address. Our aim, though, is to eventually bring you to as high a level of health as your individual situation will permit.
Once we've achieved an acceptable level of health, our aim is to then maintain that level. This includes monitoring for changes in your oral health and intervening when necessary.
As you can see, establishing a care strategy is only the beginning — and care will always be ongoing. In fact, we'll need to modify your care as new issues arise or you experience the effects of aging. Our end goal, however, always remains the same — to help you achieve and keep the most healthy and attractive mouth possible.
If you would like more information on getting the most from 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 “Successful Dental Treatment: Getting the Best Possible Results.”
It can be alarming to be awakened in the middle of the night by a screeching, gritting sound coming from your child’s bedroom. No, it’s not a scene from a horror movie: it’s your child grinding their teeth as they sleep — a behavior so prevalent in children under eleven it’s considered normal.
That doesn’t mean, however, you should completely ignore it. While it isn’t harmful for most children, a few can encounter tooth wear, pain or trouble sleeping that calls for some form of intervention.
The causes for tooth grinding and similar habits known collectively as bruxism aren’t thoroughly understood, but in children it’s believed linked to the immaturity of the neuromuscular system that controls chewing. Some point to shifts from one stage of sleep to another — more than 80% of grinding episodes occur in lighter stages of sleep and only 5% to 10% during the deeper Rapid-Eye-Movement (REM) stage. It also seems prevalent in children who snore or have other symptoms of sleep apnea.
One primary concern is how the behavior can affect teeth, particularly through abnormal wear. The teeth, of course, make hundreds of contacts with each other every day during eating, speaking or jaw movement. If, however, the forces generated during these contacts chronically exceed normal parameters, as with bruxism, it can cause accelerated tooth wear. This can result in a higher susceptibility to tooth decay and appearance changes later in life.
If your child is exhibiting problems associated with teeth grinding, there are ways to address it. We may recommend a thin, plastic mouthguard they wear while sleeping that prevents the teeth from making solid contact with each other. We may also refer you to an ear, nose and throat specialist if we suspect signs of sleep apnea. And, children under severe psychological stress, which can also trigger teeth grinding, could benefit from behavioral therapy.
The good news is most grinding habits fade as children enter their teens. In the meantime, keep a watchful eye and see us if you notice any indications this common habit is affecting their health and well-being.
If you would like more information on teeth grinding habits, 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 “When Children Grind Their Teeth.”
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