Tooth pain occurs when a trauma or infection triggers a reaction from the nerves inside a tooth's pulp chamber. The severity of the pain and its duration can vary depending on the underlying cause, which can include anything from a loose filling to an abscess. Ignoring symptoms not only results in unnecessary physical and emotional pain, but can also lead to more expensive dental treatment as problems become more complex. Make an appointment with our office today if you are experiencing any of the following symptoms:

• Sharp pain when biting down on food — This type of pain could be indicative of a cracked tooth, loose filling, or tooth decay that is affecting one or more of your teeth. We can remove decay and replace a loose filling, but if your tooth is cracked, we will have to determine the location and depth of the crack before formulating a treatment plan. In some cases, root canal treatment or even extraction may be necessary.
• Pain that lingers after eating hot or cold foods or liquids — Mild and short-term sensitivity (lasting only seconds or a minute) to hot and cold foods resulting from gum recession can often be soothed by using a fluoride toothpaste made for sensitive teeth. However, an inflamed tooth pulp or one that is dying due to severe decay could cause sensitivity that lingers for a long time after exposure. In this case, root canal treatment may be necessary to remove dying pulp tissue in order to save the tooth.
• Constant severe pain and pressure, swelling of the gums, and sensitivity to touch — Infections and/or abscesses can spread from the tooth pulp into the surrounding periodontal tissues and bone causing this type of pain. Root canal treatment will most likely be required.
• Dull ache and pressure on one or both sides of the face in the upper teeth region — The sinuses and upper back teeth share the same nerves, so, oftentimes, referred pain from sinus congestion or infection can feel like a toothache. A thorough examination can determine whether or not the pain is dentally related.

If you are experiencing tooth pain, call our office immediately so that we can begin to provide you with some relief. To read about other symptoms of tooth pain and possible treatment options, read the Dear Doctor magazine article “Tooth Pain? Don't Wait!”

When it comes to replacing missing teeth, we have numerous options. However, two of the most common treatment options include bridgework and dental implants. See how much you really know about dental implants and bridgework by taking our quick and easy true/false self test.

1. When it comes to costs, dental implants may initially cost more than bridgework but are less expensive than bridgework over a lifetime.
   True or False
2. Both bridgework and dental implants can last a lifetime when properly maintained.
   True or False
3. Prior to placing a three-unit fixed bridge, if the surrounding teeth have crowns, they must be redone so that the bridge fits and wears properly.
   True or False
4. Replacing a single tooth with a three-unit bridge, requires removing the enamel on the adjacent teeth even if these teeth are disease-free.
   True or False
5. In addition to being permanent tooth replacements, another advantage of dental implants is that they don't decay like teeth supporting bridgework.
   True or False
6. It is not uncommon for root canal treatment to be required to save teeth that support bridgework if they have been subjected to severe decay and their nerves become infected.
   True or False
7. Placing a dental implant requires more time when compared to placing a three-unit bridge.
   True or False
8. Both bridgework and dental implants require minor surgery to replace a missing tooth.
   True or False
9. Dental implants are more desirable than bridgework because placing them does not affect the adjacent teeth.
   True or False
10. Studies indicate that bridges are only 67% successful at 15 years whereas dental implants have success rates into the 90s.
    True or False

Answers: 1) True. This fact shocks many people. 2) False. This is more commonly true for dental implants. 3) True. 4) True. This is one of the disadvantages of bridgework. 5) True. This is just one of the advantages of a dental implant. 6) True. 7) True. 8) False. Dental implants require surgery to be placed. 9) True. This fact is a significant advantage for dental implants. 10) True. Your results may vary; however, this statistic represents what you might expect.

To learn more, continue reading the Dear Doctor magazine article “Implants vs. Bridgework.” Or, you can contact us today to schedule an appointment or to discuss your questions.

Thanks to technological advances, today there are more than 40 types of traditional or standard implants. A traditional dental implant actually replaces the root of a tooth, upon which a crown is built — the part you see in the mouth. There are 2 others types that are quite similar to standard implants. Mini implants are most like traditional implants except they are smaller in diameter. Micro-mini implants are an even smaller variation with an even narrower, more screw-like appearance. Micro-mini implants are also designed to be used on a temporary basis, thus can easily be removed. Together all of these types of implants provide us with a wide variety of options for permanently replacing missing teeth.

The following list details the types of implant restorations:

• Single tooth replacements: As the name suggests, these implants are used to replace single teeth.
• Multiple tooth replacements: Implants can be used to replace multiple teeth in a variety of ways. This includes acting as bridge supports to permanently replace missing teeth.
• Combinations of fixed and removable bridgework: Dental implants can be used to support permanently fixed in teeth, bridgework or removable bridges or dentures. Their biggest advantage over dentures alone is that they stabilize the dentures and preserve the jawbone to which they attach, thus preventing the jawbone from melting away under the pressure of dentures.
• Over-dentures: These restorations are now considered the new gold standard. In this application two or more standard implants (or multiple mini-implants) are used to attach and stabilize full dentures. Over-dentures are especially useful for tooth replacement in the lower jaw, where denture stability is often problematic.
• Temporary Anchorage Devices (TADS): These special implants are a tool that orthodontists can use to obtain a stable, non-movable anchor for moving teeth more quickly and easily. They are small, easy to place and easy to remove once their job is done.
• Temporary bridgework: In this case, mini-implants are used to support temporary bridgework. They are placed between permanent implants and later removed when the permanent implants have healed and teeth are permanently placed on them. Mini-implants ensure that a person is never without teeth during the process of teeth replacement.

To learn more on this topic, read the Dear Doctor article, “Dental Implants, Your Third Set Of Teeth.” Or if you prefer, you can contact us to discuss your questions or to schedule an appointment.

If you've ever looked through a magazine and viewed the perfectly aligned white smiles of celebrities and models, you may be already familiar with the look of porcelain veneers. To achieve a picture-perfect smile, many Hollywood stars choose porcelain veneers (thin-layers of porcelain) that are bonded to the front of teeth allowing for the alteration of tooth position, shape, size and color. By fixing imperfections, as well as whitening them, veneers offer celebrities a perfect smile that, when maintained properly, can last for several decades.

Evaluation: If porcelain veneers sound appealing, our office can help you decide if you're a good candidate for them. We will ensure you have sufficient tooth structure, that your teeth are in more or less a normal position, and that symmetrical gum contours are present, allowing for proper “framing” of the teeth, necessary for a beautiful smile.

The Process: Once it's been determined that you're a good candidate for veneers, our office will begin a smile analysis using computer imaging to digitally replicate your smile and then fabricate a mock-up smile made of tooth-colored wax. We will work with you to determine the right color and shade for your veneers. You can choose the brightest, whitest “Hollywood smile” or opt for a more natural color and enhanced look.

Next Steps: After your initial appointment, it typically takes the laboratory one week to fabricate your porcelain veneers. The insertion of your veneers can be done with or without a local anesthetic. We will place the veneers on your teeth with a light-sensitive resin, which sets with the use of a white light, effectively bonding them to your teeth. While you may initially experience some tooth sensitivity to hot or cold, this will disappear after a few days. Maintaining your perfect smile requires simple brushing and flossing techniques and routine check ups.

Contact us today to schedule an appointment to discuss any questions you may have regarding porcelain veneers. Read more about this topic in the Dear Doctor magazine article “Smile Design, Enhanced by Porcelain Veneers.”

Dentistry has ventured into the new area of sleep medicine by helping snorers — and their exasperated sleeping partners — with custom-made anti-snoring devices. These oral appliances, which resemble orthodontic retainers or sports mouthguards, keep the snorer's airway clear and the bedroom quiet. To see how they work, you have to understand the mechanics of snoring.

Snoring occurs when the upper airway (back of the throat) becomes blocked by the tongue or other soft-tissue structures, such as large tonsils or a long soft palate. The vibrating of these obstacles creates the sound we call snoring.

Snoring is often worse when sleeping on one's back because that position encourages the lower jaw to fall back and the tongue to close off the airway. This is where Oral Appliance Therapy comes in. These custom-fitted devices are designed to keep the upper airway open during sleep by pulling the lower jaw forward, which in turn brings the tongue away from the throat. Dentists, and our office in particular, are the only source for Oral Appliance Therapy.

People who snore should have a thorough examination to rule out Obstructive Sleep Apnea (OSA), a potentially dangerous condition in which airflow can be cut off completely for 10 or more seconds (“a” – without; “pnea” – breath), reducing blood-oxygen levels. Chronic, loud snoring is a common finding with OSA.

Please remember that sleep is an integral part of health and well-being. In fact, we spend about a third of our lives doing it. If you are snoring or have any sleep-related breathing disorders that are waking you or your bed partner, be sure to tell our office. There are plenty of examples of the havoc wreaked by sleep-deprived individuals. Remember the Exxon Valdez?

If you have any questions about Oral Appliance Therapy, please contact us or schedule an appointment for a consultation.

To learn more about the topic of oral appliance therapy, please see the Dear Doctor magazine article “Sleep Disorders & Dentistry.”