You expect a decayed tooth, a fracture or a gum infection to be the cause for that toothache causing you grief. Sometimes, though, the answer may be “none of the above”—there's nothing wrong going on in your mouth to cause the pain.
You pain is real—but its source is elsewhere in the body, a situation known as referred pain. It's important to find out the pain's true source to determine what kind of treatment you'll need to alleviate it.
Here are some of the likely candidates for a “toothache” that's not a toothache.
Facial nerves. Tooth pain may be associated with trigeminal neuralgia, a misfiring disorder of the trigeminal nerves that course through either side of the face. The nerve is divided into three branches, two of which are located in the upper face and one in the lower jaw. Because they're interconnected, a problem with one of the branches in other parts of the face could be felt in the branch around the jaw.
Jaw joints. Temporomandibular Joint Disorders (TMD) can cause pain in the pair of joints that connect the lower jaw to the skull. The joints can become inflamed due to stress or trauma and the associated muscles begin spasming, causing severe pain. Because of their proximity to the teeth, the pain from the joints can radiate into the dental area and mimic a toothache.
Ear or sinus infections. Both the ears and the maxillary sinus are subject to infections that can cause severe pain and pressure. With the close proximity of both the ears and the sinus to the upper jaw, it's quite possible for pain originating in these structures to be felt within the mouth.
These are only a few of the possibilities that also include migraines, shingles, fibromyalgia and even vitamin deficiencies. As such, your dentist or physician may need to do a little detective work to locate the true cause. But the effort to locate where your mouth pain is actually coming from will help ensure you get the right treatment to give you lasting relief.
If you would like more information on referred tooth 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 “Referred Pain: When a Toothache Is Not Really a Toothache.”
The 2019 Grammy Awards was a star-studded night packed with memorable performances. One standout came from the young Canadian singer Shawn Mendes, who sang a powerful duet of his hit song "In My Blood" with pop diva Miley Cyrus. But that duo's stellar smiles weren't always quite as camera-ready as they looked that night.
"I had braces for four and a half years," Mendes told an interviewer not long ago. "There's lots and lots and lots of photo evidence, I'm sure you can pull up a few." (In fact, finding one is as easy as searching "Sean Mendes braces.")
Wearing braces puts Mendes in good company: It's estimated that over 4 million people in the U.S. alone wear braces in a typical year—and about a quarter of them are adults! (And by the way: When she was a teenager, Miley Cyrus had braces, too!)
Today, there are a number of alternatives to traditional metal braces, such as tooth-colored braces, clear plastic aligners, and invisible lingual braces (the kind Cyrus wore). However, regular metal braces remain the most common choice for orthodontic treatment. They are often the most economical option, and can be used to treat a wide variety of bite problems (which dentists call malocclusions).
Having straighter teeth can boost your self-confidence—along with helping you bite, breathe, chew, and even speak more effectively. Plus, teeth that are in good alignment and have adequate space in between are easier to clean; this can help you keep your mouth free of gum disease and tooth decay for years to come.
Many people think getting braces is something that happens in adolescence—but as long as your mouth is otherwise healthy, there's no upper age limit for orthodontic treatment. In fact, many celebrities—like Lauren Hutton, Tom Cruise and Faith Hill—got braces as adults. But if traditional braces aren't a good fit with your self-image, it's possible that one of the less noticeable options, such as lingual braces or clear aligners, could work for you.
What's the first step to getting straighter teeth? Come in to the office for an evaluation! We will give you a complete oral examination to find out if there are any problems (like gum disease or tooth decay) that could interfere with orthodontic treatment. Then we will determine exactly how your teeth should be re-positioned to achieve a better smile, and recommend one or more options to get you there.
If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Lingual Braces: A Truly Invisible Way to Straighten Teeth.”
Even in the 21st Century, losing most or all of your teeth is still an unfortunate possibility. Many in this circumstance turn to dentures, as their great-grandparents did, to restore their teeth. But today's dentures are much different from those of past generations—and dental implants are a big reason why.
The basic denture is made of a gum-colored, acrylic base with artificial teeth attached. The base is precisely made to fit snugly and comfortably on the patient's individual gum and jaw structure, as the bony ridges of the gums provide the overall support for the denture.
Implants improve on this through two possible approaches. A removable denture can be fitted with a metal frame that firmly connects with implants embedded in the jaw. Alternatively, a denture can be permanently attached to implants with screws. Each way has its pros and cons, but both have two decided advantages over traditional dentures.
First, because implants rather than the gums provide their main support, implant-denture hybrids are often more secure and comfortable than traditional dentures. As a result, patients may enjoy greater confidence while eating or speaking wearing an implant-based denture.
They may also improve bone health rather than diminish it like standard dentures. This is because the forces generated when chewing and eating travel from the teeth to the jawbone and stimulate new bone cell growth to replace older cells. We lose this stimulation when we lose teeth, leading to slower bone cell replacement and eventually less overall bone volume.
Traditional dentures not only don't restore this stimulation, they can also accelerate bone loss as they rub against the bony ridges of the gums. Implants, on the other hand, can help slow or stop bone loss. The titanium in the imbedded post attracts bone cells, which then grow and adhere to the implant surface. Over time, this can increase the amount of bone attachment and help stymie any further loss.
An implant-supported denture is more expensive than a standard denture, but far less than replacing each individual tooth with an implant. If you want the affordability of dentures with the added benefits of implants, this option may be worth your consideration.
If you would like more information on implant-supported restorations, 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 “Overdentures & Fixed Dentures.”
Tooth decay is one of two dental diseases most responsible for tooth loss (gum disease being the other). In the absence of treatment, what starts as a hole or cavity in a tooth's outer layers can steadily advance toward its interior.
Most people associate cavities with the crown, the part of a tooth you can see. But cavities can also occur in a tooth's roots, especially with older adults. Root cavities pose two distinct difficulties: They can lead to more rapid decay spread than crown cavities within a tooth; and they're harder to detect.
Tooth roots are ordinarily covered by the gums, which protects them from bacterial plaque, the main cause for decay. But roots can become exposed due to receding gums, a common problem with seniors who are more susceptible to gum disease.
Unlike the enamel-covered crowns, tooth roots depend on gum coverage for protection against bacteria and the acid they produce. Without this coverage, the only thing standing between tooth decay and the roots is a thin material called cementum.
If decay does enter a tooth's interior, saving it often requires a root canal treatment to remove decayed tissue in the inner pulp and root canals, and then replacing it with a filling. But if we're able to discover a root cavity in its early stages, we may be able to fill it like a crown cavity.
The best strategy, though, is to prevent root cavities from forming. This starts with a dedicated daily regimen of brushing and flossing to remove dental plaque. If you're at high risk for root cavities, we may also recommend antibacterial mouthrinses and other aids.
Regular dental visits are also a must: a minimum of twice-a-year dental cleanings to remove stubborn plaque and calculus (hardened plaque) deposits. For added protection against root cavities, we can also apply fluoride varnish to strengthen teeth. And regular visits are the best way to detect any cavity in its early stages when treatment is less invasive.
A heightened risk of dental problems like root cavities are a part of the aging process. But partnering together, we can lower that risk and increase the longevity of your teeth.
If you would like more information on root cavities, 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 “Root Cavities.”
“My tooth hurts…or maybe more than one. Or, it might be my gums.”
If you're having trouble describing the pain in your mouth, don't feel bad. Although our body's pain mechanism is great for alerting us to a problem, it can't always tell us the true cause and location of that problem.
That's especially true of tooth pain. It could be a sign, for instance, of decay within a tooth's inner pulp. When under attack, the nerves in the pulp often send out pain signals that could be sharp, dull, continuous, intermittent, seeming to come from one tooth or several.
If this is the case, depending on how deep the decay is, you could need a filling to resolve the problem or, if it's more extensive, possibly a root canal treatment to save the affected tooth. If you need a root canal, after removing the pulp's diseased tissue, the procedure calls for filling the empty pulp chamber and root canals to prevent future infection.
Another possibility for the pain is gum disease that has also infected the tooth. Gum disease usually begins with the bacteria in dental plaque, a thin biofilm that builds up on tooth surfaces, which infect the gums. If not treated promptly, the infection can advance below the gum line to the tooth roots and supporting bone. From there, it could invade the tooth and travel through the root canals to the interior pulp.
In this scenario, we'll need to treat the gum disease by removing plaque and tartar (hardened plaque) deposits from all tooth and gum surfaces. This is usually done manually with hand instruments or ultrasonic equipment, but it may also require surgical access to infected areas around the roots. If the tooth's nerve has become involved, we may also need to perform a root canal treatment as described above.
There are three key points to take from these two tooth pain scenarios. First, the only way to determine the true cause of your pain (and what treatment you'll need) is with a dental exam. Second, the sooner your pain is diagnosed and you begin treatment, the better your outcome—so see your dentist at the first sign of pain or other symptoms like swollen or bleeding gums.
And finally, you may be able to prevent these and other dental problems by removing disease-causing plaque through daily brushing and flossing and professional teeth cleaning every six months. Prevention through effective oral hygiene may help you avoid a future bout of mysterious tooth pain.
If you would like more information on treating tooth 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 “Confusing Tooth Pain.”
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