Archive for the ‘Dental Emergencies’ Category

This month I would like to discuss another dental issue and problem that many people (approximately 40 Million Americans) suffer with: Sensitive teeth.

Teeth are composed of enamel on the outside and the dentin which lies just under the enamel. Dentin contains very small tubes that have fluid in them.  When hot, cold, chemicals such as whitening agents or sweets pass by the surface of the dentin on the exposed roots and edges of teeth it moves the fluid in the micro tubes and this causes the pain by stimulating the nerve.  So when pain is felt it is actually an indirect contact with the nerve through this system and not a direct touching of the nerve.

The following are the most frequent causes of tooth sensitivity:

• Brushing with excessive pressure with hard toothbrush bristles. Over time this aggressive act will take away the gum tissue, the bone and then the tooth leading to exposed root dentin which will make the teeth sensitive.  The use of a soft toothbrush using a gentle circular motion aiming at the gumline is the best way to safely brush the teeth without harm. I am often asked what is the best toothbrush?   I say a soft manual brush or even better is an electric brush like the Sonicare.  They are gentle on the teeth and effective on plaque removal while infusing oxygen into the plaque which helps to kill the bacteria between the teeth.
• Periodontal disease will cause bone loss around the teeth giving the “long in the teeth” appearance. Some people falsely believe that this is a part of the natural aging process but it isn’t.  Periodontal disease is caused by a bacterial invasion under the gum line which eventually causes the bone to be lost.  Smokers and uncontrolled diabetics are the ones who are most likely to be diagnosed with this disease.
• Grinding of the teeth from stress can create loss of bone and tooth structure where the root meets the gum. This is called an abfraction and is like a deep notch in the tooth.  When one grinds their teeth the teeth flex and under the right conditions these notches can deepen and become sensitive.  A small guard can prevent this from happening and an evaluation is necessary to make sure the bite is proper.  Sometimes it may be necessary to adjust the bite.
• Abrasive toothpastes such as those containing baking soda can be harmful and abrade the tooth roots.
• Acidic foods and beverages such as soft drinks can cause tooth pain by decaying the tooth. I had a patient recently ask me if lemon in the water can cause the sensitive teeth because she was using a lot of lemon.  This certainly increases the acid level in the mouth and causes them to be sensitive. Acid reflux especially at night is a contributing factor in that the stomach acid is very strong which leads to loss of enamel.  Bulimia  also makes the teeth exposed to the strong acids in the stomach, leading to really sensitive teeth.

These are the most common causes that lead to sensitive teeth.  Treatment includes such things as: fluoride rinses at home, tooth pastes such as Sensodine, Renamel and a number of other toothpastes which have a chemicals in them that literally “clogs” up the small microtubes in the dentin.  When these get “clogged up” they can’t transmit the fluid within the micro tubes and pain is reduced.  We have stronger “clogging agents”  that can be applied in the office which can make a significant difference in pain.   You must remember that  hard tooth brushing and acids will dissolve the reparative plugs that are formed so it is necessary to change the habits that have created the sensitive teeth in the first place.  It is best to visit your dentist to have this evaluated.  If you don’t have a current dental home then I would be happy to evaluate your situation so give us a call at (586)247-3500.

About The Author

Dr. Robert Antolak, DDS graduated from the University of Michigan in 1987 with his Doctor of Dental Surgery degree. He is dedicated to providing the highest quality and appropriate cosmetic, sedation and general dentistry in the most comfortable and gentle way possible. Because being a dentist has been a lifelong dream, Dr. Antolak has a passion for the profession. He enjoys helping people feel better about their smiles and therefore their self-image with dental implant and cosmetic dentistry. His Dental Practice is located in Shelby Township, Michigan.  For more information visit The Gentle Dentist.

Dentistry can bring on night sweats, rapid heart beat, hyperventilation and all of the symptoms of a huge anxiety rush.  This type of feeling is usually felt before a dental appointment for those who have had bad experiences.

These bad events can stay with people for decades.  The level of fear can last for many years because the fear is ingrained into that person’s memory.  Because we deal with very close spaces and are directly in one of the most sensitive and personal areas on the human body trust must be one of the most importent issues that the dental patient must have.

Modern dentistry has equipped ourselves to deal with these issues to make visits much more comfortable.  For example, we use sedation to put people in a state where they have no memory of their procedure and are very relaxed when they get to the office and during the procedures.  It also allows for them to get many services done at one visit so they don’t have to continually return to our office.  Another option is to plug in a DVD into our virtual reality glasses and watch a movie.

It is critical to have dental procedures pain free.  Anesthetics properly administered do a great job in controlling pain and therefore anxiety, and as a result trust starts to become developed.

Because fear comes from a loss of control it is very important that you are in complete control of the procedure and have a way of stopping if you need a break or are in pain and in need of additional anesthesia.

Anxiety stems from fear of the unknown and when you are not sure the anxiety increases.  It is also very helpful if all of your questions are answered when you need additional information.

Because relationships are so important and can’t be stressed enough we have personal interviews with the patient so that their needs are met and so that there are no misunderstandings.

Please don’t let your bad experiences affect your present condition. Modern dentistry emphasizes prevention over all other things so do yourself a favor and don’t delay this any longer.   Your needs will be met and you will be comfortable having treatment as this is my promise. You will be amazed at how easy and user friendly dental care can be.

It is easier said than done, but don’t be embarrassed if you haven’t been to a dentist in years and are afraid of past judgments from the dentist.   A modern dentist will help you look forward to your future care and would never lecture you.

The effects of cancer treatment on the mouth can be quite severe!

Most people realize the side effects of radiation and chemotherapy which are hair loss and nausea, but 1 out of 3 people develop problems with the mouth during and even after treatment.  These complications such as dry mouth or life threatening infections may interfere with cancer treatment or diminish the quality of living and eating. It is therefore important to have a qualified dentist as part of the oncology team who can manage and prep the patient’s mouth in anticipation of these complications.  This preoperative care for the cancer treatment is a vital part in a comprehensive approach to overall patient comfort and satisfaction.

Cancer treatment kills fast growing cells and saliva producing cells are one of the fast growing types.  As a result, cancer patients can have extremely dry mouths eliminating the lubrication, re-mineralization, and healing enzyme properties of saliva.

Dental cavities, infection of the soft tissues, periodontal disease and other dental diseases are exacerbated and made worse when saliva is either reduced or eliminated.  Therefore it is critical to involve your qualified dentist to treat decay with fillings, treat periodontal disease, extract hopeless teeth and either remake or reline poorly fitting dentures.

If at all possible your first dental visit should be at least 1 month before cancer treatment begins to give the treating dentist enough time to complete treatment.  Once the cancer treatment begins it is too late to have the dental work done because the bodies healing capacity and ability to fight off infections is greatly reduced if not stopped.

Since the mouth is full of disease causing bacteria any potential dental problem that can be foreseen should be treated immediately with enough time to heal completely (around 14 days) before cancer treatment is started.  Open wounds, infected teeth and the like can be seeds to serious problems.  Any elective oral surgery such as implant placement should be postponed until after cancer treatment is completed.  Soft plastic trays can be used to hold fluoride to prevent tooth decay.  These are to be used during the night to re-mineralize the teeth.

The diagnosis of cancer is devastating for everyone involved and there are both emotional and physical aspects that must be dealt with right away.  Involving the dentist as part of your care isn’t usually considered, but is critical.  Since time is of the essence, being told to wait a week for a dental appointment isn’t acceptable to me.  If your dentist isn’t willing to either alter his/her schedule or come in on their day off you may want to contact our office for an immediate appointment.  For more information on what a patient should do before, during and after cancer treatment you can call our office at (586) 247-3500 for a free reprinted brochure from the National Institute of Health.  You can also visit their website at Http://www.nidcr.nih.gov/OralHealth/cancertreatment

Even if you have questions about this topic or if you or a loved one is to be starting cancer therapy you can call me or visit the office to discuss your questions.

If you are involved with a cancer support group and would like to have me speak to them about oral care before, during and after cancer therapy you can email me at DrAntolak@TheGentleDentist.com.

I am also available to talk with support groups or even patients who are about to begin cancer treatment.