When your child says they have a toothache, should you see your dentist? In most cases, the answer is yes.
And for good reason: their “toothache” could be a sign of a serious condition like tooth decay or a localized area of infection called an abscess, which could adversely affect their long-term dental health. The best way to know for sure –and to know what treatment will be necessary—is through a dental exam.
So, how quickly should you make the appointment? You can usually wait until morning if the pain has persisted for a day or through the night—most toothaches don’t constitute an emergency. One exception, though, is if the child has accompanying fever or facial swelling: in those cases you should call your dentist immediately or, if unavailable, visit an emergency room.
In the meantime, you can do a little detective work to share with the dentist at the appointment. Ask your child exactly where in their mouth they feel the pain and if they remember when it started. Look at that part of the mouth—you may be able to see brown spots on the teeth or obvious cavities indicative of decay, or reddened, swollen gums caused by an abscess. Also ask them if they remember getting hit in the mouth, which may mean their pain is the result of trauma and not disease.
You can also look for one other possible cause: a piece of candy, popcorn or other hard object wedged between the teeth putting painful pressure on the gums. Try gently flossing the teeth to see if anything dislodges. If so, the pain may alleviate quickly if the wedged object was the cause.
Speaking of pain, you can try to ease it before the dental appointment with ibuprofen or acetaminophen in appropriate doses for the child’s age. A chilled cloth or ice pack (no direct ice on skin) applied to the outside of the jaw may also help.
Seeing the dentist for any tooth pain is always a good idea. By paying prompt attention to this particular “call for help” from the body could stop a painful situation from getting worse.
If you would like more information on dental care for children, 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 “A Child’s Toothache: Have a Dental Exam to Figure out the Real Cause.”
Although cancer treatment has advanced steadily in recent decades, the most used therapies continue to be radiation and chemotherapy to eradicate cancerous cells. And while they often work, both can cause "collateral damage" in healthy tissues near the targeted cells.
This can create a number of indirect consequences for a patient's health, including in the mouth. The salivary glands, for example, can be damaged by radiation treatments aimed at the head or neck. The effect on these glands can interrupt the normal flow of saliva and cause xerostomia or "dry mouth."
Lack of adequate saliva causes more than an unpleasant, sticky mouth feeling. One of saliva's main functions is to neutralize acid that builds up naturally after eating. Without it, high acid levels can cause enamel and root surface erosion and lead to tooth decay.
Cancer treatment can also contribute to gastro-esophageal reflux disease (GERD). This disease causes stomach acid to bypass the natural tissue barriers of the esophagus and enter the mouth. As with dry mouth, the increased acid level from GERD can be just as devastating to enamel—and the damage will be permanent.
To minimize these effects on your dental health, it's important to take proactive steps before, during and after cancer treatment. If at all possible, have any needed dental work performed before you begin radiation or chemotherapy—it's better to start it with teeth and gums as healthy as possible.
During treatment, try to continue regular dental visits to monitor your oral health and receive any needed preventive or therapeutic treatments. Depending on your condition and the advice of your dentist, you may need to increase your visit frequency during this time. Your dentist can help with boosting your saliva production and strengthening your tooth enamel. But you should also practice daily brushing and flossing, drink plenty of water and seek treatment for any resulting GERD symptoms.
Even with the best efforts, though, your teeth and gums may still incur damage while treating your cancer. Fortunately, there are a wide array of materials and procedures that can effectively restore them to health. So, once your treatments are completed consult with a dentist on your options for improving the health and appearance of your teeth and gums.
The March 27th game started off pretty well for NBA star Kevin Love. His team, the Cleveland Cavaliers, were coming off a 5-game winning streak as they faced the Miami Heat that night. Less than two minutes into the contest, Love charged in for a shot on Heat center Jordan Mickey—but instead of a basket, he got an elbow in the face that sent him to the floor (and out of the game) with an injury to his mouth.
In pictures from the aftermath, Love’s front tooth seemed clearly out of position. According to the Cavs’ official statement, “Love suffered a front tooth subluxation.” But what exactly does that mean, and how serious is his injury?
The dental term “subluxation” refers to one specific type of luxation injury—a situation where a tooth has become loosened or displaced from its proper location. A subluxation is an injury to tooth-supporting structures such as the periodontal ligament: a stretchy network of fibrous tissue that keeps the tooth in its socket. The affected tooth becomes abnormally loose, but as long as the nerves inside the tooth and the underlying bone have not been damaged, it generally has a favorable prognosis.
Treatment of a subluxation injury may involve correcting the tooth’s position immediately and/or stabilizing the tooth—often by temporarily splinting (joining) it to adjacent teeth—and maintaining a soft diet for a few weeks. This gives the injured tissues a chance to heal and helps the ligament regain proper attachment to the tooth. The condition of tooth’s pulp (soft inner tissue) must also be closely monitored; if it becomes infected, root canal treatment may be needed to preserve the tooth.
So while Kevin Love’s dental dilemma might have looked scary in the pictures, with proper care he has a good chance of keeping the tooth. Significantly, Love acknowledged on Twitter that the damage “…could have been so much worse if I wasn’t protected with [a] mouthguard.”
Love’s injury reminds us that whether they’re played at a big arena, a high school gym or an outdoor court, sports like basketball (as well as baseball, football and many others) have a high potential for facial injuries. That’s why all players should wear a mouthguard whenever they’re in the game. Custom-made mouthguards, available for a reasonable cost at the dental office, are the most comfortable to wear, and offer protection that’s superior to the kind available at big-box retailers.
If you have questions about dental injuries or custom-made mouthguards, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Field-Side Guide to Dental Injuries” and “Athletic Mouthguards.”
If your dentist found tooth decay on your last visit, you might have been surprised. But tooth decay doesn't occur suddenly—it's a process that takes time to unfold.
It begins with bacteria—too many, that is. Bacteria naturally live in the mouth, but when their populations grow (often because of an abundance of leftover sugar to feed on) they produce high amounts of acid, a byproduct of their digestion. Too much acid contact over time softens and eventually erodes tooth enamel, making decay easier to advance into the tooth.
So, one important strategy for preventing tooth decay is to keep your mouth's bacterial population under control. To do that, here are 4 common-sense tactics you should perform between dental visits.
Practice daily hygiene. Bacteria thrive in dental plaque, a thin film of food particles that builds up on teeth. By both brushing and flossing you can reduce plaque buildup and in turn reduce disease-causing bacteria. In addition, brushing with a fluoride toothpaste can also help strengthen tooth enamel against acid attacks.
Cut back on sugar. Reducing how much sugar you eat—and how often –deprives bacteria of a prime food source. Constant snacking throughout the day on sweets worsens the problem because it prevents saliva, the body's natural acid neutralizer, from reducing high acid levels produced while eating. Constant snacking doesn't allow saliva to complete this process, which normally takes about thirty minutes to an hour. To avoid this scenario, limit any sweets you eat to mealtimes only.
Wait to brush after eating. Although this sounds counterintuitive, your tooth enamel is in a softened state until saliva completes the acid neutralizing process previously described. If you brush immediately after eating you could brush away tiny particles of softened enamel. Instead, rinse your mouth out with water and wait an hour for saliva to do its work before brushing.
Boost your saliva. Inadequate saliva flow could inhibit the fluid's ability to adequately neutralize acid or provide other restorative benefits to tooth enamel. You can improve flow with supplements or medications, or by drinking more water during the day. Products with xylitol, a natural sugar alternative, could give you a double benefit: chewing gums and mints containing it could stimulate more saliva flow and the xylitol itself can inhibit bacterial growth.
Today’s dentist can not only treat most dental diseases and conditions, but can almost prevent disease completely. Our true needs as a society, however, go beyond the dentist’s chair — to the lack of availability and affordability of care for every American.
That’s of grave concern to dentists — so much so that dentistry itself is already changing to meet these challenges.
In one of the most visible changes, we’re seeing accelerated technological advancement that could lower costs and extend our range of care. Advances in 3-D digital imaging are giving dentists amazingly detailed views of patients’ mouths that surpass the accuracy of traditional imaging. Telecommunications and the internet are enabling dentists in distant locations to examine patients and even review dental x-rays to guide treatment, providing a new level of care access for patients.
The means for delivering that care are also changing as the traditional paradigm of the solo practice becomes more difficult for new dentists to achieve. With educational debt and practice setup costs reaching as high as $1 million — before earning their first dollar — many dentists are joining larger groups or dental corporations. In these arrangements, practitioners don’t have the burden of overhead expenses and can concentrate mainly on their clinical work. On the downside, patients seeing multiple providers may not easily build that all important dentist-patient relationship that’s the hallmark of a solo practice. This alternative model could, however, increase the number of practicing dentists over time, making dental care more widely available.
Finally, we’re beginning to see greater collaboration between physicians and dentists. There’s an emerging understanding of the true interconnection of the body’s various systems: diseases of the mouth can affect other diseases of the body, and vice-versa. We’re also experiencing a growing development in salivary diagnosis, using this vital oral fluid to detect conditions and disease in other parts of the body. Dentists and physicians will be working more closely than ever to treat the whole person, not just individual systems — a collaboration that will improve patient care all around.
As these changes continue to emerge in dentistry, you may soon see their effects during your visits. One thing, however, won’t change — the commitment of dentists to provide the highest level of care, for both your oral and general health.
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