Each year doctors treat about 150,000 new cases of severe facial pain. If you're one of those people, you don't have to suffer—there are ways to gain relief from these painful episodes.
Those recurring episodes are known as trigeminal neuralgia (TN). As the name implies, the source of the pain are the trigeminal nerves, which originate in the brain stem and extend on either side of the face. Each is divided into three branches (hence the "tri" in trigeminal) that serve the upper, middle and lower parts of the face and jaw.
TN can involve one or more of these branches, resulting in mild to severe pain that can last for several seconds. Jaw movements like chewing or speaking can trigger an episode, as well as a light touch to the face.
There are various proposed causes for TN, including links with inflammatory disorders like multiple sclerosis, which damages the insulating sheathing around nerve cells. The most common cause, though, appears to be a blood vessel pressing against the nerve. The compression causes hypersensitivity in that area of the nerve so that it transmits pain at the slightest sensation.
Other conditions like jaw joint pain disorders (TMD) or a dental abscess can cause similar pain symptoms, so it's important to get an accurate diagnosis. If your doctor does identify your condition as TN, you may then need a comprehensive approach to treatment involving a team of care providers, including your dentist.
For the most part, TN can be managed, beginning with the most conservative approach to gain relief, often with medications to block the nerve's pain signals to the brain or decrease abnormal nerve firings. If that proves insufficient, though, more intensive treatments are available.
One possible treatment for an impinging blood vessel is a microsurgical procedure to expose the affected nerve and relocate the vessel. While this can be effective, the surgery does carry some risk of facial numbness or decreased hearing. If the risks are too high for conventional surgery, an alternative procedure uses a precise beam of high-dose radiation to relieve the pressure from the vessel.
The most important thing to know about TN, though, is that it is possible to control it and relieve future pain episodes. If you're experiencing these symptoms, see your dentist or doctor for an exam and accurate diagnosis.
If you would like more information on trigeminal neuralgia, 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: A Nerve Disorder that Causes Facial Pain.”
Ed Helms is best known for his role as the self-absorbed, Ivy League sales rep, Andy Bernard, on television's The Office. But to millions of fans he's also Stu, a member of a bachelor trip to Las Vegas in the 2009 movie The Hangover. In it, Stu and his friends wake up from a wild night on the Strip to find some things missing: the groom-to-be, their memories and, for Stu, a front tooth.
In reality, the missing tooth gag wasn't a Hollywood makeup or CGI (computer-generated imagery) trick—it was Ed Helm's actual missing tooth. According to Helms, the front tooth in question never developed and he had obtained a dental implant to replace it. He had the implant crown removed for the Hangover movie and then replaced after filming.
Helms' dental situation isn't that unusual. Although most of the 170 million-plus teeth missing from Americans' mouths are due to disease or trauma, a few happened because the teeth never formed. While most of these congenitally missing teeth are in the back of the mouth, a few, as in Helms' case, involve front teeth in the “smile zone,” which can profoundly affect appearance.
Fortunately, people missing undeveloped teeth have several good options to restore their smiles and dental function. The kind of tooth missing could help determine which option to use. For example, a bridge supported by the teeth on either side of the gap might work well if the teeth on either side are in need of crowns.
If the missing tooth happens to be one or both of the lateral incisors (on either side of the centermost teeth), it could be possible to move the canine teeth (the pointy ones, also called eye teeth) to fill the gap. This technique, known as canine substitution, may also require further modification—either by softening the canines' pointed tips, crowning them or applying veneers—to help the repositioned teeth look more natural.
The optimal solution, though, is to replace a missing tooth with a dental implant which then has a lifelike crown attached to it, as Ed Helms did to get his winning smile. Implant-supported replacement teeth are closest to natural teeth in terms of both appearance and function. Implants, though, shouldn't be placed until the jaw has fully developed, usually in early adulthood. A younger person may need a temporary restoration like a bonded bridge or a partial denture until they're ready for an implant.
Whatever the method, there's an effective way to restore missing teeth. Seeing us for an initial exam is the first step toward your own winning smile.
Dental implants are all the rage—and for good reason: They’re incredibly “tooth-like,” both in appearance and function. They also have a stunningly high success rate: More than 95% of implants still function after ten years. This means out of thousands of implants installed each year, only a handful fail.
But although that’s an amazingly low number, they’re still failures for real people who’ve suffered a loss. If you’re considering dental implants the chances of that being your experience are quite low. But it could still happen.
Here’s a few things you can do to make sure your implants don’t fail.
Stop smoking. Of the small percentage of implant failures, an inordinate number are smokers. A smoker’s chances of implant failure are roughly double those of non-smokers. Smoking, and to some degree any tobacco use, can make your mouth an unhealthier place: Not only can it increase your dental disease risk, but it can interfere with the healing process after implant placement and increase the chances of early failure.
Manage your health. Diabetes and similar systemic conditions can interfere with the healing process too, which could impact your implant attachment to bone. Diabetics thus run a slight risk of implant failure—but actual failures mostly involve patients who don’t have good control of their symptoms. If you’re a diabetic, properly managing your condition will lower your risk of implant failure to nearly identical that of someone without diabetes.
Treat gum disease. Implants in themselves are immune to disease—but the underlying bone that supports them isn’t. A gum disease infection could eventually weaken and diminish the implant-bone attachment. If this happens around an implant, its stability can be severely compromised. The best strategy is to prevent gum disease through daily, thorough brushing and flossing to remove disease-causing dental plaque. And if you see any symptoms like gum swelling, redness or bleeding, see your dentist as soon as possible.
Your implants could serve you well for decades. Just be sure you’re doing the right things to ensure their longevity.
If you would like more information on dental implants, 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 “Dental Implants: A Tooth-Replacement Method That Rarely Fails.”
First the bad news: Those nightly hair-raising sounds are indeed coming from your child’s bedroom—from your child. It’s the result of them grinding their teeth while they sleep.
But here’s the good news: the only likely harm is a lack of sleep members of your household might experience because of it. Teeth grinding is so prevalent among pre-teen children that many healthcare professionals consider it normal. But that doesn’t mean it can’t become a problem, so it’s worth monitoring.
Teeth grinding is part of a family of dental habits known as bruxism. It involves any involuntary movement of the teeth and jaws outside of their intended functions not associated with chewing, speaking or swallowing. Our main concern with any bruxism is the possibility for generating stronger biting forces than normal that could damage teeth and gums and contribute to jaw joint problems.
Teeth grinding can occur in adulthood, with stress seeming to be the major trigger for it. With children, though, it’s believed to be mainly caused by an immaturity of the child’s neuromuscular process that controls chewing. As this matures, most children will tend to outgrow the habit none the worse for wear.
But there are pediatric cases in which the generated biting forces are strong enough to cause damage. Teeth grinding is also prevalent in children who snore or breathe through their mouths, which could be a sign of a serious health condition called obstructive sleep apnea. And certain medications used to treat depression and attention deficit disorder (ADHD) may also contribute to teeth grinding.
Most of the time we can simply let the habit run its course. If, however, the child begins to experience abnormal tooth wear, headaches, jaw pain or other issues believed caused by teeth grinding, we may need to intervene. This could include a plastic night guard the child wears during sleep that prevents the teeth from making solid contact during grinding episodes. And children with signs of airway obstruction should be evaluated by an ear, nose and throat specialist.
It can be irritating or even distressing. But your child’s teeth grinding doesn’t mean you should be alarmed—only that you should keep your eye on it.
If you would like more information on teeth grinding and similar habits, 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 “When Children Grind Their Teeth.”
To keep a healthy smile, brushing and flossing your teeth every day should be at the top of your to-do list, along with regular dental visits. Dental visits are usually scheduled every six months when your dental professional will remove any built-up plaque and tartar (hardened plaque deposits) missed during everyday hygiene.
If you've experienced periodontal (gum) disease, however, these dental visits may become even more important toward preventing a re-infection. For one thing, your dentist may want to see you more frequently.
Gum disease is caused by bacteria living in dental plaque, which first infect the superficial layers of gum tissue. Even though the body initiates an inflammatory response to fight it, the infection continues to grow as long as there is plaque present to fuel it. The problem isn't just plaque on the visible tooth surface—hidden plaque beneath the gum line can create deep pockets of infection that can be difficult to treat.
To stop the infection, dentists must manually remove plaque through procedures known as scaling and root planing. Any and all plaque and tartar deposits must be removed, even those deep around the roots, to arrest the infection. This often requires several treatment sessions and sometimes gum surgery to access areas below the gum line.
These types of treatments, especially in the disease's early stages, have a good chance of restoring health to your gums. But because of the high possibility of reinfection, your dentist will need to step up your regular dental maintenance from now on. This could mean visits as frequent as every few weeks, depending on your particular case of gum disease and your dentist's recommendation.
Your dental visits after gum disease may also become more involved than before. Your dentist will now monitor you closely for any signs of reinfection and at the first sign initiate a new round of treatment. You may also need surgical procedures to make some areas around your teeth more accessible for future cleaning and maintenance.
Periodontal maintenance after gum disease helps ensure another infection doesn't rise up to undermine your progress. To paraphrase a well-known quote, eternal vigilance is the price of continuing good dental health.
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