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Life would be harrowing if we had no ability to feel pain. Although experiencing it is unpleasant, pain's purpose is to alert us to something wrong in our body. Without pain diseases and other problems could worsen to the point of life-threatening.
But pain without a purpose — the nerves simply misfiring — can make life miserable. This can happen with the trigeminal nerves that exit the brain stem and end on each side of the face. Each nerve has three branches that serve the upper, middle and lower parts of the face and jaw.
When they don't work properly, trigeminal nerves can give rise to a disorder known as trigeminal neuralgia. Beginning often as an occasional twinge, they may escalate to several seconds of mild to excruciating pain occurring over weeks, months or even years. An episode may erupt from chewing, speaking or even lightly touching of the face.
We see this condition most often in people over fifty, particularly women. We don't know the exact cause, but there's strong suspicion that the nerve's protective sheath has been damaged, similar to what occurs with multiple sclerosis or other inflammatory conditions. Another possibility is a blood vessel putting pressure on the nerve and disrupting its normal operation. Such an impinged nerve might transmit pain signals at the slightest stimulation and then fail to “switch off” when the stimulation stops.
Although we can't cure trigeminal neuralgia, we can help you manage it and reduce discomfort during episodes. We'll first try conservative, less-invasive techniques, like signal-blocking medications or drugs that reduce abnormal firing.
If these aren't effective, we may then recommend a surgical solution. One such procedure is known as percutaneous treatment in which we insert a thin needle to selectively damage nerve fibers to prevent their firing. If we've determined an artery or vein has compressed the nerve, we might surgically relocate the vessel. These techniques can be quite effective but they do have possible side effects like numbness or hearing loss.
If you've experienced facial pain, don't continue to suffer. Visit us for a complete examination and learn about your options for pain relief. More than likely, there's a way to reduce your pain and improve your quality of life.
If you would like more information on facial pain, 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.”
At the first-ever Players Weekend in August 2017, Major League Baseball players wore jerseys with their nicknames on the back. One player — Cleveland Indians shortstop, Francisco Lindor — picked the perfect moniker to express his cheerful, fun-loving nature: “Mr. Smile.” And Lindor gave fans plenty to smile about when he belted a 2-run homer into the stands while wearing his new jersey!
Lindor has explained that he believes smiling is an important part of connecting with fans and teammates alike: “I’ve never been a fan of the guy that makes a great play and then acts like he’s done it 10,000 times — smile, man! We’ve got to enjoy the game.”
We think Lindor is right: Smiling is a great way to generate good will. And it feels great too… as long as you have a smile that’s healthy, and that looks as good as you want it to. But what if you don’t? Here are some things we can do at the dental office to help you enjoy smiling again:
Routine Professional Cleanings & Exams. This is a great place to start on the road toward a healthy, beautiful smile. Even if you are conscientious about brushing and flossing at home, you won’t be able to remove all of the disease-causing dental plaque that can hide beneath the gum line, especially if it has hardened into tartar, but we can do it easily in the office. Then, after a thorough dental exam, we can identify any problems that may be affecting your ability to smile freely, such as tooth decay, gum disease, or cosmetic dental issues.
Cosmetic Dental Treatments. If your oral health is good but your smile is not as bright as you’d like it to be, we can discuss a number of cosmetic dental treatments that can help. These range from conservative procedures such as professional teeth whitening and bonding to more dramatic procedures like porcelain veneers or crowns.
Tooth Replacement. Many people hide their smiles because they are embarrassed by a gap from a missing tooth. That’s a shame, because there are several excellent tooth-replacement options in a variety of price ranges. These include partial and full dentures, bridgework, and dental implants. So don’t let a missing tooth stop you from being Mr. (or Ms.) Smile!
If you’d like more information about oral health or cosmetic dentistry, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Beautiful Smiles by Design” and “The Impact of a Smile Makeover.”
Dental sealants are one of the most significant dental materials in preventive dentistry, alongside topical fluorides. They are also called pit and fissure sealants.
Pits and fissures are similar to the grooves on the biting surfaces of the back teeth, but are deeper and inaccessible to brushes while cleaning, making them highly susceptible to dental caries (decay) formation. Dental sealants are a plastic material (resin) applied to the surfaces of these teeth to block the deep pits and fissures from trapping food. If food is not trapped within the fissures, no caries are likely to form. Sealants are a safe and effective method for preventing caries and can be applied by your local dentist.
The advantages of sealants are primarily seen in children when they are applied to the pits and fissures of back teeth immediately upon eruption of the crowns. A sealant prevents decay from forming in the first place, and are highly recommended in children with high caries activity. Sealing the teeth helps prevent the agony of going to the dentist for frequent fillings. Adults can also benefit from dental sealants if they experience a change in their diet or medical condition that renders them highly susceptible to caries, such as patients who have undergone recent radiotherapy to face and neck.
The dental sealant material is a low-viscosity fluid resin that flows easily to the depths of the narrow fissures. It is applied after cleaning the tooth thoroughly with polishing material. The tooth surface is washed, dried and etched using a mild acid (35-50% phosphoric acid) to allow the resin to stay in place. The resin is cured after application using a visible light source. It is a completely painless procedure and no shots need be taken. Sometimes your local dentist may widen the fissures with a dental bur to allow proper sealing and to remove small caries lesions.
Clinical studies have also shown that sealants can be applied over small decay with no further progression deeper into the tooth. This causes the decay to stop immediately, effectively trapping it. However, this procedure is not highly recommended at present. If used along with topical fluoride application, dental sealants have shown to reduce caries incidence up to 75%.
Dental sealants can get dislodged under heavy pressure, so frequent examination and repair (if needed) every 6 months is advised for proper protection. Dental sealants are highly recommended for those individuals who love their teeth, but can't spend enough time on their proper maintenance.
When most people think of root canals, they cringe because they think that the procedure is extremely painful. The truth is that a root canal procedure is really no more painful than having a cavity filled. The techniques used during root canal, along with the pain reduction options offered by most dentists, make a root canal a fairly pain-free and routine procedure.
What exactly is a root canal? The procedure removes the nerve and internal pulp of an infected or badly decayed tooth. Root canals are typically performed if the decay within a tooth becomes severe enough to cause damage to the pulp of the tooth or the nerve or there is an infection deep within the tooth, or abscess. The infection or abscess is the result of decay within the tooth that breaks down and forms bacteria. Once the nerve and pulp is removed, the inside of the tooth is cleaned up and then sealed.
When a root canal procedure is recommended, the first thing that needs to be done is to take an x-ray so that the nerve, pulp and surrounding area can be clearly seen by the dentist. Once that is completed and the dentist knows the extent of the damage and what needs to be removed, the patient can undergo the root canal procedure. A local anesthetic is typically administered to avoid any pain during the procedure. A rubber dam is then placed around the tooth to keep it dry while the procedure is performed.
During the procedure, the root and pulp of the tooth is removed and then the interior of the tooth is cleaned out using root canal files. None of this hurts because an anesthetic has been administered. The tooth is then sealed. If the area of decay was extensive, it may be recommended that further restorative treatments be performed at a later time to keep the tooth strong and to avoid any future problems.
One of the reasons that root canals have gotten such a reputation for being so painful is due to the fact that there is typically a great deal of pain experienced in a tooth prior to the procedure, which is the reason the root canal is needed in the first place. The procedure itself should be relatively pain-free and patients should experience little or no discomfort following a root canal treatment.