Every year 150,000 people, mostly women over age 50, find out they have a painful condition called trigeminal neuralgia. For many it begins as an occasional twinge along the face that steadily worsens until the simple act of chewing or speaking, or even a light touch, sets off excruciating pain.
The source of the pain is the pair of trigeminal nerves that course along each side of the face. Each nerve has three separate branches that provide sensation to the upper, middle and lower areas of the face and jaw.
The problem arises when areas of the myelin sheath, a fatty, insulating covering on nerves, becomes damaged, often because of an artery or vein pressing against it. As a result, the nerve can become hypersensitive to stimuli and transmit pain at even the slightest trigger. It may also fail to stop transmitting even after the stimulation that caused it is over.
Although the condition may not always be curable, there are various ways to effectively manage it. The most conservative way is with medications that block the nerve from transmitting pain signals to the brain, coupled with drugs that help stabilize the nerve and decrease abnormal firing.
If medication isn't enough to relieve symptoms, there may be some benefit from more invasive treatments. One technique is to insert a thin needle into the nerve to selectively damage nerve fibers to prevent them from firing. Another microsurgical procedure attempts to relocate the nerve away from a blood vessel that may be compressing it.
The latter procedure has some higher risks such as facial numbness or decreased hearing, and is often better suited for younger patients. Older patients may benefit more from the needle insertion procedure previously mentioned or a directed beam of high-dose radiation to alter the nerve.
To learn the best options for you, you should first undergo a neurological exam to verify you have trigeminal neuralgia and to rule out other causes. From there, you and your doctor can decide the best course of treatment for your age and individual condition.
Trigeminal neuralgia can be an unpleasant experience. But there are tried and true ways to minimize its effect on your life.
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.”
Among the “to-do” items on your pre-dive checklist like “Pack wetsuit” or “Fill scuba tanks,” be sure to add one other: “Check my dental health status.”
While that may seem like an odd concern, the changes in atmospheric pressure you encounter while diving (or flying, for that matter) could amplify oral sensitivity and intensify pain if you have pre-existing teeth or jaw problems.
The reason for this is the effect of basic physics on the body. All anatomical structures, including organs, bones and muscles, equalize external pressures the body encounters. We don’t notice this at normal atmospheric pressure, but when we encounter an extreme — either lower pressure during air flight or higher pressure during a scuba dive — we may feel the effects of the pressure on any structure with a rigid-walled surface filled with either air or fluid. These structures can’t equalize the pressure as fast as other areas, resulting in pain or discomfort. This is known medically as “barotrauma,” or more commonly as a “squeeze.”
One structure in particular could have an effect on your upper teeth and jaws: the sinus cavities of the skull, particularly the maxillary sinuses just below the eyes. Their lower walls are right next to the back teeth of the upper jaw and, more importantly, share the same nerve pathways. It’s quite possible, then, for pain from one area to be felt in the other, commonly known as “referred pain.” A toothache could then be felt in the sinus region, and vice-versa.
During a squeeze, then, pain levels from existing problems in the teeth and jaws that were previously tolerable (or even unnoticed) may well become amplified as the pressure from the sinus cavity impinges upon the jaw. That dull toothache you’ve been having may suddenly become excruciating at 30,000 feet — or 30 meters under the surface.
That’s why it’s important to see us if you’ve experienced any signs of tooth decay, gum disease or TMD, including pain, before your next dive or air flight. And, if you encounter any significant pain while flying or diving, be sure you consult with us as soon as possible when you return. Taking action now could help you avoid a miserable, and potentially dangerous, flying or diving experience in the future.
If you would like more information on pressure changes and dental health, 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 “Pressure Changes can Cause Tooth and Sinus Pain.”
If there's anything that makes Alfonso Ribeiro happier than his long-running gig as host of America's Funniest Home Videos, it's the time he gets to spend with his family: his wife Angela, their two young sons, and Alfonso's teenaged daughter. As the proud dad told Dear Doctor–Dentistry & Oral Health magazine, "The best part of being a father is the smiles and the warmth you get from your children."
Because Alfonso and Angela want to make sure those little smiles stay healthy, they are careful to keep on top of their kids' oral health at home—and with regular checkups at the dental office. If you, too, want to help your children get on the road to good oral health, here are five tips:
- Start off Right—Even before teeth emerge, gently wipe baby's gums with a clean, moist washcloth. When the first teeth appear, brush them with a tiny dab of fluoride on a soft-bristled toothbrush. Schedule an age-one dental visit for a complete evaluation, and to help your child get accustomed to the dental office.
- Teach Them Well—When they're first learning how to take care of their teeth, most kids need a lot of help. Be patient as you demonstrate the proper way to brush and floss…over and over again. When they're ready, let them try it themselves—but keep an eye on their progress, and offer help when it's needed.
- Watch What They Eat & Drink—Consuming foods high in sugar or starch may give kids momentary satisfaction…but these substances also feed the harmful bacteria that cause tooth decay. The same goes for sodas, juices and acidic drinks—the major sources of sugar in many children's diets. If you allow sugary snacks, limit them to around mealtimes—that gives the mouth a chance to recover its natural balance.
- Keep Up the Good Work—That means brushing twice a day and flossing at least once a day, every single day. If motivation is an issue, encourage your kids by letting them pick out a special brush, toothpaste or floss. You can also give stickers, or use a chart to show progress and provide a reward after a certain period of time. And don't forget to give them a good example to follow!
- Get Regular Dental Checkups—This applies to both kids and adults, but it's especially important during the years when they are rapidly growing! Timely treatment with sealants, topical fluoride applications or fillings can often help keep a small problem from turning into a major headache.
Bringing your kids to the dental office early—and regularly—is the best way to set them up for a lifetime of good checkups…even if they're a little nervous at first. Speaking of his youngest child, Alfonso Ribeiro said "I think the first time he was really frightened, but then the dentist made him feel better—and so since then, going back, it's actually a nice experience." Our goal is to provide this experience for every patient.
If you have questions about your child's dental hygiene routine, call the office or schedule a consultation. You can learn more in the Dear Doctor magazine article “How to Help Your Child Develop the Best Habits for Oral Health.”
Dental implants are among the most popular tooth replacements with their high success rate, durability and life-like beauty. But obtaining them is a process that requires commitment, planning, and coordination — it takes a team.
Your general dentist is often the first team member you’ll encounter: because they’re most familiar with your mouth’s condition the implant discussion naturally begins here. They can help you determine if you’re a good candidate for implants, such as if you have sufficient bone mass at the intended site or if you have dental disease that must be treated first. They’ll also continue monitoring your general dental health throughout the process.
Your general dentist may also have the special training for surgically placing implants. If not, he or she may refer you to your next team member: an oral surgeon or periodontist skilled in implantation procedures. This step first requires careful planning, including developing a surgical guide for precise placement of the implant. These specialists may also contribute to other aspects of the implant process such as tooth extraction or bone grafting.
A few weeks after surgery bone will have grown and adhered to the implant to form a solid bond. It’s time for you to go back to your dentist who will work in conjunction with another member of your team, a dental lab technician. Together, your dentist and laboratory technician will guide the development, manufacture and placement of the implant’s life-like porcelain crown. The technician will take their specifications from the surgeon and your general dentist and, with his or her skill and artistry, form a crown that will blend well in color and shape with the rest of your teeth.
We also can’t forget another important team member: you. Without your input, especially in the early planning stages, your expectations for a more attractive smile might not be met. The rest of your implant team depends on you communicating your desires and wishes to balance with the technical requirements they must achieve.
The process for dental implants can take months. But with the coordinated efforts of your implant team you’ll be able to enjoy results — renewed function and a more attractive smile — that could last for decades.
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.”
Facing extensive dental treatment can be stressful—and even more so when you realize what it will cost. It’s a hard fact of life, but some dental work can be expensive.
The good news, though, is that it’s possible to keep your costs at a manageable level, even with limited finances. And your best first step is to become proactive with dental care now, before problems appear or get worse.
There are good reasons for making room in your budget for regular dental cleanings and checkups: for one, dental cleanings coupled with your own daily hygiene help keep bacterial plaque, the main cause of dental disease, from causing gum disease or damage to the tooth surfaces. And seeing us regularly makes it more likely we’ll detect a problem before it inflicts too much harm.
Regular visits are also important for establishing a relationship with us. As we become more familiar with you and your own individual risk factors for dental problems, we can then develop a treatment strategy to minimize those risks or take action to decrease their impact.
The latter point has direct bearing on the financial side of your care. It’s tempting to postpone a recommended treatment for a mild to moderate issue because of the expense. But receiving treatment now could save you from major expense later.
Perhaps, though, you’re actually facing that major expense now and the full weight of what it will cost is bearing down. Even in this situation, you may actually find there are less expensive ways to deal with the problem, at least temporarily until you can afford a more permanent solution.
For example, if you’ve lost a tooth or have had it extracted, you may be able to opt for a partial denture or similar less costly restoration—at least for the time being. Eventually, when you’re prepared financially, you can replace it with a dental implant or another permanent restoration. In the meantime, you’re able to regain a reasonable level of dental health.
The key is to invest in your teeth and gums now whatever their state of health. The efforts you make today could save you from a greater health and financial burden tomorrow.
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