Tags Posts tagged with "Tooth Sensitivity"

Tooth Sensitivity

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Filling Fell Out of Front Tooth
©MicroWorks/Shutterstock.com

I got an email earlier this week from a reader named Trish.  She asked the following:

“What will happen if the filling comes out of your tooth, and you don’t have it replaced, other than pain trying to eat?”

Lost Filling from ToothBefore I answer that question, let’s take a look at why fillings fall out.  A  filling normally doesn’t fall out of your tooth just for fun – it usually has a pretty good reason!  Fillings can come out because of decay around the filling, because the filling cracked, or because it wasn’t put in properly.

Basically, if your filling fell out, chances are that there was something wrong and you should get your tooth looked at by a dentist.

If the filling came out and it was recently put in, your dentist might give you a break and put a new filling in.  If it was an old filling and it just came out, you may have a cavity under the filling.

Regardless of why the filling fell out, it’s important to replace it.  To answer Trish’s question, here’s a list of eight things that could happen to your tooth if your filling fell out and you don’t have it replaced.

Eight Things that Can Happen If You Don’t Replace a Lost Filling

1 – Sensitivity

When you lose a filling, it exposes the sensitive dentin (the inner hard layer of your tooth) to your mouth.  Depending on how close the filling was to the pulp of your tooth, it could hurt all the time or only when you eat, as Trish mentioned above.  Either way, the pain means that there’s something wrong that needs to get taken care of!

Not sure what dentin and pulp are?  Check out my article on the anatomy of a tooth to find out!

2 – Root Canal

The pulp inside of your tooth could get irritated, causing pulpitis.  The textbook Clinical Endodontics by Leif Tronstad states, “Factors leading to an infectious pulpitis are conditions that contribute to the exposure of the dentin and dentinal tubules to the oral environment.”

3 – It’s Harder to Clean

Teeth are hard to clean when they have a big gaping hole in them.  Even if you can get the toothbrush bristles down to the bottom of the hole where the filling was, chances are that you won’t be able to easily clean out the entire hole where the filling was located.

4 – Bad Breath

When you eat food, the natural contours of the teeth allow you to efficiently chew and grind the food into little, easily-digested pieces.  When you have a hole in your tooth and you chew, you push the food down into the hole.  Since teeth with lost fillings are more difficult to clean (see #3), that food could be sitting in there for quite some time and cause your breath to be less than pleasant to those around you!  Even if you do have bad breath, people probably aren’t going to tell you.

5 – Tooth Decay

Because the tooth is harder to clean and you’re buyonlinegenericmeds.com grinding food into it every time you eat, it’s much easier for you to get a cavity in that tooth.  If the reason that you lost the filling was because you had a cavity under it, the cavity will probably get bigger the longer treatment is put off.

6 – The Tooth Could Crack or Break

If the tooth goes for a long time with a lost filling, it may develop a cavity, which can subsequently weaken the tooth structure and cause the tooth to break or crack.  Without the filling, the tooth will also experience different forces that end up causing it to break.

7 – Difficulty Repairing Tooth With a White Filling

When you lose a filling and expose the dentin to your saliva, the dentin reacts by trying to fight off the bacteria.  The little tubules inside the dentin eventually close off to try to protect the nerve of the tooth.  When this happens, it is known as sclerotic dentin.  A problem with sclerotic dentin is that it is much harder to get a white filling to bond to sclerotic dentin than it is to get a white filling to bond to regular dentin.

8 – The Tooth May Need to Be Extracted

If you wait too long, the tooth may break and become so badly decayed that it is what dentists like to call unrestorable.  That means that just like Humpty Dumpty, nobody will be able to put that tooth back together again, and it will have to come out.

What Are Your Options When a Filling Falls Out?

I assume that Trish wants to know what would happen because she either has a fear of the dentist or can’t afford to get a new filling right now.

If fear is keeping you away from the dentist, take a look at this article about reasons people are scared of the dentist, and then figure out your fear and try to overcome it.  There is help available online at sites like Dental Fear Central.

If cost is keeping you away from the dentist, then you can call your dentist and ask how much a temporary filling would cost.  A temporary filling would allow you to get the tooth filled fairly inexpensively until you can save up for a permanent filling.  An even more temporary solution is to try some temporary filling materials until you can see your dentist.  I talk about a few different brands in my article about what you should do when you lose a filling from your tooth.

Conclusion

If you have a filling come out, it’s necessary to get the filling replaced as soon as possible to ensure the long-term health of your tooth.  If you can’t afford it, there are temporary solutions available that you dentist may discuss with you.

Do you have any questions, comments, or concerns about losing a filling from your tooth?  Go ahead and leave a comment in the comments section below and I’ll get back to you.  Thanks for reading!

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Tooth Pain and Sinus Infections
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This past weekend, my wife told me that she was having the worst toothache of her life. When she came in for her checkup a few months ago, her teeth were in great shape.

Dental Sinus InfectionShe told me that the pain was constant and that it got worse when she stood up. I told her that I thought it was a sinus infection. She went to the doctor and found out that she did have a sinus infection.

Stories like my wife’s are fairly common — many people think that they have a problem with their teeth when they simply have sinusitis.

What Are Sinuses?

Each time you take a breath through your nose, air travels through your sinuses on its way down to your lungs.  Your sinuses are simply hollow, air-filled cavities in your upper jaw bone.  They are lined with a pink membrane that is similar to the pink lining on the inside of your mouth.

When the lining of your sinuses gets infected or inflamed, it is known as sinusitis.

Many people end up coming to the emergency room at our dental school with painful teeth.  Upon examination, we sometimes find that their teeth are healthy and that the real cause of their pain is a sinus infection or sinusitis.

How Your Sinuses Can Cause Tooth Pain

Below you’ll find a dental x-ray.  I outlined the floor of the maxillary sinus (the sinus located above your upper teeth) so that you can see how close it comes to the roots of your upper molars.

Maxillary Sinuses on a Dental X-Ray

On the left side, it looks like the sinus floor goes below the roots of the upper molars.  Usually this isn’t the case, and that illusion can be attributed to overlap as we are seeing a two dimensional image of a three dimensional object.  However, it does give you a pretty good idea of why sinus infections can make it seem like you have a toothache in your upper molars and premolars.

Want more details on how a tooth can cause a sinus infection? Then read this article: Can a Sinus Infection Be Caused by a Tooth?

How to Know If The Pain Is Coming From a Tooth or Your Sinuses

When a patient comes in with severe tooth pain, we normally take an x-ray of the offending tooth.  Tooth pain is usually caused by reversible and irreversible pulpitis.

We also do some tests on the tooth by feeling around it for an infection, tapping on it, and/or putting ice on it.  This allows us to better understand if the pain is coming from one tooth or not.

If the teeth don’t have any cavities in them and appear to be healthy, then we usually try to find another source of the pain, such as a sinus infection (sinusitis).

Symptoms of a Maxillary Sinus Infection

Although there are other sinuses, the main pair of sinuses that affect your upper teeth are the maxillary sinuses.  One of the main symptoms of maxillary sinusitis is continuous pain in your back upper teeth that changes (gets worse or better) when you move your head (such as lying down or standing up.)

Treatment of Maxillary Sinusitis

Maxillary sinusitis can be treated in a variety of ways.  Here are some common treatments for maxillary sinusitis:

  • Using a humidifier to moisten the air that you breathe in.  This helps to loosen any dried secretions that have accumulated in the sinuses.
  • Using nasal spray that contains phenylephrine or ephedrine.
  • Taking decongestants orally such as Sudafed (psedoephedrine)
  • Taking antibiotics if it is believed that the sinusitis is caused by bacteria.  Common antibiotics that are prescribed for sinusitis include amoxicillin, trimethoprimsulfamethoxazole, clavulanate with amoxicillin, azithromycin, and cefuroxime.

Conclusion

Although toothaches are generally caused by a problem with your tooth, it is important to understand that your teeth have neighbors, such as your sinuses, that can mimic a toothache.

Do you have any questions about sinusitis or sinus infections?  I’d love to hear what you have to say in the comments section below.  I’ll do my best to respond to your questions, comments, and/or concerns.  Thanks for reading!

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Teeth Whitening Side Effects
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Did you know that more than half of all people who bleach their teeth end up with sensitive teeth as a result?  It seems like people are willing to go through a lot just to get whiter teeth.  In this article, I’m going to talk about the two main side effects of whitening your teeth: tooth sensitivity and sore gums.

Sensitive Teeth

Teeth Whitening Side EffectsTooth sensitivity is the most common side effect of teeth whitening.  It can range from very mild tooth sensitivity to a sharp, shooting type of pain.  Almost always, the sensitivity goes away within a few weeks and no permanent harm is done to the teeth.  But, in rare cases, irreversible tooth damage can occur according to this page on the American Dental Association’s website.

When I whitened my teeth last year, I ended up with really sensitive teeth and had to stop after a few nights to keep my teeth from driving me crazy!

This study from the American Dental Association found out the following during a study about tooth sensitivity after teeth whitening:

“Fifty-four percent of subjects in both test and controlgroups reported mild sensitivity; 10 percent of test subjectsand 2 percent of control subjects reported moderate sensitivity;4 percent of test subjects and no control subjects reportedsevere sensitivity. Sensitivity decreased with time; by thesecond week, no severe sensitivity was reported, and by thefourth week, no moderate sensitivity was reported.”

How to Stop Sensitive Teeth Caused by Teeth Whitening

There are desensitizing gels available that can be applied to your teeth either before or after whitening your teeth.  These gels contain similar ingredients to those found in toothpastes for those with sensitive teeth.

This study found that using a desensitizing gel before getting your teeth whitened at the dental office actually reduced the amount of tooth sensitivity that a patient experiences.  In the words of the researchers, “The use of a desensitizing gel (5 percent nitratepotassium/2 percent sodium fluoride) before in-office bleachingdid not affect the bleaching efficacy but did reduce tooth sensitivity.”

Your dentist can also give you desensitizing gel if your tooth sensitivity does not seem to be decreasing within a reasonable time after the procedure..

Sore Gums

The second main side effect of teeth whitening is sore gums.  There are a couple of theories as to why you get sore gums with teeth whitening.

Hydrogen peroxide is able to cause chemical burns (much like aspirin) on the inside of your mouth.  One theory suggests that since hydrogen peroxide is present when you whiten your teeth, it can irritate your gums.

Most teeth whitening gels contain carbamide peroxide which ends up breaking down into hydrogen peroxide to whiten the teeth.

Another theory as to why you get sore gums when you whiten your teeth doesn’t have to do with the whitening gel – it is caused by the tray that holds the whitening gel up against your teeth.  The ADA says that “Tissue irritation, in most cases, results from an ill-fitting tray rather than the tooth-bleaching agents.”

How to Stop Sore Gums Caused by Teeth Whitening

If you often have sore gums after you whiten your teeth, you can often solve the problem by getting a tray that fits better.  Dentists can make teeth whitening trays that are custom made to fit your teeth and that hold the gel on your teeth rather than on your gums.  If that doesn’t work, it may be best to take a break from whitening your teeth to keep your gums from hurting.

What to Do If You Develop These Teeth Whitening Side Effects

The dental textbook Sturdevant’s Art and Science of Operative Dentistry states “If either of the two primary side effects occurs (i.e., sensitive teeth or irritated gingiva), the patient should reduce or discontinue treatment immediately and contact the dentist so that the cause of the problem can be determined and the treatment approach modified.  The dentist may prescribe desensitizing agents to help alleviate sensitivity associated with bleaching.”

Conclusion

Although these are the two main side effects, there are other side effects that have been suggested such as:

  • Nausea
  • Sore Throat
  • TMJ disorder due to tray usage
  • Alteration of the normal bacteria leading to taste-bud enlargement
  • Oral infection

If you experience any of these side effects associated with teeth whitening, get in touch with your dentist to get more information on your individual situation.  Sometimes having pearly whites is not worth the discomfort and possible damage to your teeth!

Have you ever had any of these teeth whitening side effects?  What happened?  I’d love to hear your stories, comments, and questions in the comments section below.  Thanks for reading!

Cold Sensitive Teeth
©Jan Mika/Shutterstock.com

Does the thought of eating ice cream or any cold foods make you cringe because you know how bad your teeth will hurt? You could be one of the millions of Americans that suffer from sensitive teeth. While the causes of sensitive teeth can vary, there are some toothpastes that can help alleviate the symptoms.

Ice Cream Sensitive TeethIf your teeth are sensitive and you don’t think that it is caused by reversible or irreversible pulpitis, then you may want to try a toothpaste that is made especially for sensitive teeth.

Toothpastes made for sensitive teeth usually contain two extra ingredients that help decrease painful tooth sensitivity.  These two extra ingredients are:

Potassium Nitrate and Strontium Chloride.

Both of these ingredients work by acting on the dentin tubules.  In order to understand how these ingredients work, I will first give a brief explanation of dentin tubules.

What Are Dentin Tubules?

The dentin tubules are tiny tubes that go from the outside of your teeth (when dentin is exposed to the outside surface, which usually happens with gum recession) to the dental pulp.  If the dentin tubules are openly exposed to the inside of your mouth, then it is easy for sensations to be transferred to the nerves in the dental pulp.

It is this transmission of various stimuli, such as heat, cold, and sweets, that cause the nerves to send the message of pain to your brain.  After all, the only sensation that the dental pulp can send to the brain is the sensation of pain.