If you’re pregnant, you may find yourself pondering decisions you didn’t have to think about before. Should you have that glass of wine… or skip it, because of the alcohol; go for the sushi… or avoid uncooked foods; take the pain reliever… or live with the headache. And if you have a toothache — or even if you’re overdue for a checkup and a cleaning — you may also be wondering whether having dental treatment (especially treatment that might involve local anesthetics) is safe for you and your developing baby.
Fortunately, a study that recently appeared in the Journal of the American Dental Association (JADA) should let expectant moms breathe a little easier. The research concludes that it’s safe for pregnant women to undergo dental treatment, including procedures that use local anesthetics.
And that’s good news indeed, because while maintaining good oral health during pregnancy is critical for the developing baby, many expectant moms experience problems during this period.Â Some common issues include a higher risk of tooth decay due to increased carbohydrate consumption, and sore or bleeding gums from a condition called pregnancy gingivitis.
According to the study’s lead author, Aharon Hagai, D.M.D., "[Pregnancy] is a crucial period of time in a woman’s life, and maintaining oral health is directly related to good overall health." Yet, as Dr. Hagai notes, pregnant women sometimes avoid the dentist even if they have a problem. So his team set out to determine whether having dental treatment with anesthesia affected the outcome of pregnancies. They compared a total of 1,004 women, some of whom had dental treatment with local anesthesia, and some who did not.
The research showed there was no significant difference between the two groups. This applied in terms of both major medical problems (such as cleft palate, heart defects or cerebral palsy) and other issues, including low birth weight and preterm delivery. Dr. Hagai summed it up this way: "We aimed to determine if there was a significant risk associated with dental treatment with anesthesia and pregnancy outcomes. We did not find any."
So if you’re pregnant, there’s one less thing to worry about. Go ahead and schedule your routine dental check up — and remember that it is particularly important to have cleanings during pregnancy. Â If you experience changes in your oral health, don’t hesitate to come in for an office visit and cleaning; that way, you can make sure your hormonal changes are not playing havoc with your gums. There is an old saying in some cultures that for every child a woman has, she loses a tooth. Don’t let that happen to you.
If you have questions about oral health and pregnancy, please call our office to schedule a consultation. You can read more in the Dear Doctor magazine article “Expectant Mothers: Dental facts you need to know” and “Pregnancy and Oral Health.”
A toothache might mean you have tooth decay—or maybe not. It could also be a sign of other problems that will take a dental exam to uncover. But we can get some initial clues about the underlying cause from how much it hurts, when and for how long it hurts and where you feel the pain most.
Let's say, for instance, you have a sharp pain while consuming something cold or hot, but only for a second or two. This could indicate isolated tooth decay or a loose filling. But it could also mean your gums have receded and exposed some of the tooth's hypersensitive root surface.
While over-aggressive brushing can be the culprit, gum recession is most often caused by periodontal (gum) disease. Untreated, this bacterial infection triggered by accumulated dental plaque could eventually cause tooth and bone loss, so the sooner it's attended to the better.
On the other hand, if the pain seems to linger after encountering hot or cold foods and liquids, or you have a continuous throbbing pain, you could have advanced tooth decay that's entered the inner pulp where infected tooth nerves are reacting painfully. If so, you may need a root canal treatment to remove the diseased pulp tissue and fill the empty pulp and root canals to prevent further infection.
If you have this kind of pain, see a dentist as soon as possible, even if the pain stops. Cessation of pain may only mean the nerves have died and can no longer transmit pain; the infection, on the other hand, is still active and will continue to advance to the roots and bone.
Tooth pain could also indicate other situations: a cracked tooth, an abscess or even a sinus problem where you're feeling the pain radiating through the teeth. So whatever kind of pain you're feeling, it's your body's alarm signal that something's wrong. Promptly seeing your dentist is the best course of action for preserving your health.
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 “Tooth Pain? Don't Wait!”
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
While you do all you can to provide your child healthy meals and snacks at home, they still face tempting choices for unhealthy fare when they’re away. Unfortunately, their school campus could be one of those places with food choices that raise their risk for dental disease.
Thankfully, that situation is beginning to change. The U.S. Department of Agriculture (USDA) issued regulations a few years ago tightening minimum health standards for snacks available on school grounds. Called the Smart Snacks in Schools initiative, it promotes whole grains, fruits, vegetables and low-fat dairy products, while discouraging snacks with empty calories, fat, sugar and excessive salt. This is good news in particular for preventing tooth decay in children and teenagers.
Unfortunately, the initiative may not go far enough. There are a few “loopholes”: it allows for chocolate milk with added sugar as long as it’s fat-free; high schools can also sell beverages like sports and energy drinks, which are low in sugar but high in enamel-harming acid. So, although the general nutrition of snacks in schools may be improving, you should still remain alert to poor choices that may fall through the cracks.
For one thing, you can advocate for better nutrition policies in your child’s school. The USDA initiative is a minimum standard — schools can exceed them and eliminate borderline snacks allowed under the federal regulations.
You can also provide your child snack alternatives to the school vending machine. A little creativity and fun can go a long way: a dash of cinnamon or parmesan cheese on popcorn instead of butter; finger sandwiches made of real cheese on whole-grain bread (with some whimsical shaping with a cookie-cutter); or bite-sized fruits and vegetables like grapes, baby carrots or nuts. The more healthy (and enjoyable) snacks you can send with them, the less chance they’ll turn to a less nutritious choice in the vending machine.
A healthier approach to snacking depends on setting good examples, providing ample selections and accentuating the positive about healthy foods. Choosing nutritious foods, at home and away, is a key building block for healthy teeth and gums.
If you would like more information on nutrition 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 “Snacking at School.”
Determining which of your teeth is causing your toothache isn’t always easy — or even if it’s a tooth at all. The pain could be coming from a tooth, the gums, or both. Only a thorough dental examination can pinpoint the exact cause and best course of treatment.
If a decayed tooth is the problem, the pain may be coming from nerves and other tissue deep within the tooth’s pulp. The symptoms could be dull or sharp, constant or intermittent, specific to one area or spread out. It’s even possible for the pain to suddenly subside after a few days. This doesn’t mean the infection has subsided, but rather that the infected nerves have died and no longer transmit pain. Pain can also radiate from the actual source and be felt somewhere else — the pain in your sinuses, for example, could actually originate from an infected back tooth.
If the source is periodontal (gum) disease, the infection has begun in the gum tissues. As they become more inflamed they lose their connectivity with the teeth, bone loss occurs and the gums may “recess” or draw back. This exposes the tooth root, which without the protective cover of the gum tissues becomes highly sensitive to changes in temperature or pressure. As a result you may encounter sharp pain when you eat or drink something hot or cold, or bite down.
Treating these issues will depend on the actual infection source. An infected tooth often requires a root canal treatment to clean out the pulp and root canals of dead or infected tissue, fill them with a special filling, and seal and crown the tooth to prevent future infection. If the source is gum disease, we must manually remove the bacterial plaque causing the disease from all tooth and gum surfaces to stop the infection and allow the gums to heal. In advanced cases, surgical procedures may be necessary to repair damage and encourage new gum and bone growth.
Where dental disease has spread from tooth to gums or vice-versa, you may need treatments for both areas to address your overall condition. Whatever the treatment course, we can put an end to your tooth pain and restore health to your teeth and gums.
If you would like more information on the sources of mouth pain, please contact us today to 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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