Dealing with Acid Reflux (GERD)? Watch Your Teeth!

So, you have just come home from a great night of Mexican food – the bean dip was fabulous, chips and salsa were great, and the enchiladas, beyond compare! Now you are dealing with that familiar burning pain in your chest, those feelings of regurgitation: the symptoms of Gastroesophageal Reflux Disease (GERD). What you may not realize is that the same acid that is causing you such discomfort may actually be eating away at the enamel of your teeth, making you susceptible to tooth decay.

GERD is a common problem today and occurs when ring of muscle between the esophagus and the stomach fails to close, allowing the contents of the stomach to flow back up into the esophagus. The high acidity of the stomach contents is what causes the burning sensation in the chest. Eventually the acid can eat away at the lining of the esophagus, producing even more serious complications.

What effect does all this extra acid have on your mouth? Saliva in your mouth is designed to maintain the proper pH balance (levels of acidity or alkalinity) in your mouth. For example, eating sugar causes the acid level of your mouth to rise, putting your teeth at risk. The saliva in your mouth works to restore the balance after sugar consumption. Imagine the effect of continual acid coming up from your stomach due to GERD and entering your mouth – the acidic assault should make dental news headlines as much as the warnings about highly acidic foods, drinks, and sugar.

Acid eats at the enamel that protects your teeth. When the enamel begins to wear off, the sensitive inner layer of your teeth, called dentin, is exposed. This can produce symptoms of tooth erosion, which include:

● Toothache
● Bad breath
● Spots on teeth
● Sensitivity to hot, cold, or sweet

Tooth decay can lead to more serious dental issues which could lead to permanent damage or loss of teeth requiring the care of cosmetic dentistry. Because of the serious effects of excess acid in the mouth NY dental professionals recommend following a strict regimen to deal with GERD quickly. Certain dietary and lifestyle choices contribute to GERD, including eating chocolate, peppermint, fried or fatty foods, coffee, and alcoholic beverages. Smoking has also been shown to relax the muscle that contributes to GERD.

If you have been diagnosed with GERD, or you are experiencing the symptoms, you should let your dentist know. If you have already suffered damage to your teeth, you may want to visit a cosmetic dentist. Manhattan area dentists are well equipped both to protect your teeth from damage, and to help you recover your beautiful smile.

Do I Need a Root Canal?

People often have the misconception that root canal therapy is a painful experience and mistakenly believe that having an infected tooth removed is a preferable choice. Also known as endodontic (“endo” – inside; “dont” – tooth) treatment, a root canal will relieve the severe pain that is caused when the tooth nerve has become inflamed. Unfortunately, extracting an infected tooth can introduce many additional problems that could be avoided with a root canal.

A root canal may be necessary if a deep cavity or trauma to the tooth has occurred, causing the inside pulp to become infected or inflamed. Often, pressure develops inside the core of the tooth which is the source of sharp, lingering pain when biting down or when exposed to temperature changes, particularly from hot foods and liquids. Sometimes, a dull ache may be present and the gum may be sensitive to pressure. Left untreated, an abscess may develop and infection can spread from the tooth to the surrounding bone, and even into the bloodstream.

Immediate dental treatment for a suspected endodontic infection is always the best course of action, and the treatment is relatively pain free and is performed under a local anesthetic administered by the dentist. First, the dentist will have to x-ray the suspicious tooth to diagnose the problem and will sometimes test the tooth to determine whether the nerve is in the process of dying. Once it has been determined that an infected tooth requires a root canal, and the tooth and surrounding area are numb, a small opening is made into the tooth, just as if one were having a filling placed. The infected, dying nerve and blood vessels are removed and the root canals are smoothed, cleaned, disinfected and filled with a rubber material. Some patients feel slight tenderness around the tooth for a day or two, but generally aspirin or ibuprofen will provide sufficient relief. After the nerve has been removed a tooth is no longer living, and the lack of blood supply causes it to become brittle over time. Your dentist will almost always advise you to have a crown placed on an endodontically treated tooth to protect it.

Most of the time a root canal can be performed in a single appointment and the crown will require two more visits to complete. The end result is that you will have kept your natural tooth and restored it to full function. Because bone loss and shifting of the remaining teeth often result when a tooth is extracted, the root canal avoids these complications as well.If you are confronted with the recommendation to have root canal treatment, or if you are experiencing unexplained pain when chewing or to temperature, don’t hesitate to inquire about your options or ask for further information about endodontic treatment to restore your smile and comfort. Have you had a positive experience with root canal therapy? We would like to hear your comments… and they may even help alleviate the concerns of others.

Grinding and Clenching

Unexplained soreness of the jaw or neck muscles and persistent headaches could be an indication that you are suffering from bruxism, or grinding and clenching of the teeth.  The problem is treatable and more common that you may realize, even though most people are completely unaware that they do it.

Frequently, people who clench and grind their teeth do so during sleep, and learn about it from their sleep partner.    Sometimes bruxism is discovered when clients ask their dentist about pain or an odd sensation that their teeth are loose. However, the habit can create a long list of symptoms from mild to significant and can be quite destructive to the teeth themselves as well as to supporting structures, causing the gum recession and bone loss which can eventually cause teeth to be lost. Among people who chronically grind, fractured teeth and damage to the nerves which can require root canal therapy are common.  Unfortunately, this treatable behavior can exist for a long time before it is diagnosed, because many of the symptoms can be easily overlooked or ignored, and may be thought to have another cause.  Consider bringing to your dentist’s attention any of the following symptoms:

• Earache
• Headaches or Migraines
• Loose teeth
• Changes in the way your teeth fit together
• Sensitive teeth
• Tinnitus
• Gum recession
• Neck pain
• Insomnia
• Soreness of the jaw or neck

Bruxism is thought to run in families but it is also be a common response to stress, anxiety and depression. Other causes of the habit include bite problems, eating disorders, excessive alcohol use, and medical conditions such as Parkinson’s disease and obsessive compulsive disorder.  Ideally, treating bruxism involves managing or eliminating the cause but obviously, this is not always possible andtreatment for the behavior and its symptoms often focuses on interruption of the grinding, relieving stress on the jaw joint and and preventing damage to the teeth .

Careful examination of the teeth may reveal fine cracks, wear facets in the tooth anatomy, and otherwise unexplained changes in the bone around the teeth. These findings, along with a thorough medical history will help your dentist diagnose bruxism and suggest a treatment plan.  Most frequently, a hard plastic occlusal splint is custom made to fit the teeth. Worn while sleeping, this “nightguard ”  protects the teeth by covering their surface and enabling them to  glide easily.  The night guard is form-fitting, covers all of the upper teeth and  prevents them from shifting over time which ultimately prevents gradual changes in how teeth  fit together.  A different type of  FDA approved appliance called an NTI(Nociceptive Trigeminal Inhibition system)  fits only over the upper front teeth and prevents the back teeth from touching at all.  Other treatment options including biofeedback, hypnosis, dietary supplements and (rarely) Botox injections are less well known and have had mixed or questionableresults.

People who have been grinding their teeth for a long time may have significantly damaged their teeth;  in severe cases they can even be worn down to the gum line. The damage may have left teeth  sensitive and susceptible to cavities, and may have even caused changes in the shape of your face or the way you feel about your smile. The first step in addressing these issues is always to treat the  bruxism  so that no further damage occurs; and the good news is that there are several cosmetic options that can improve the function of your teeth as well as their appearance.      Your cosmetic dentist may suggest crowns, veneers or bonding as part of your complete treatment  plan.

Unexplained symptoms may not be as mysterious as you think… why not talk to your dentist about bruxism and what treatment options may be right for you?  You deserve a beautiful, pain-free smile!

Childhood Dental Emergencies: What Every Parent Needs To Know

Childhood Dental Emergencies: What Every Parent Needs To Know

Childhood injuries are frightening, and certainly no one wants to see a child having pain; but in the heat of the moment it is sometimes hard to know what constitutes a dental emergency and what can wait until Monday. The truth is that it is often a judgment call, but having some guidelines can alleviate anxiety, help with on-the-spot decision making and may prevent a manageable problem from becoming a big one.

A head injury can be life-threatening and it may have resulted in a jaw or facial fracture. Both situations require immediate medical attention. Never leave a person unattended if they have suffered a head injury, and remember that the emergency medical team can often reach you faster than you can get to the hospital.

Soft-tissue injuries of the tongue, cheeks, gums, and lips are very common and they result in bleeding which is often very profuse- and very frightening – both to parents and to the injured person, making it difficult to tell how severe an injury actually is. The most important first step is to control it:

• • Rinse the mouth with a mild, warm (not hot) salt-water solution.
  • Use a moist piece of gauze or tea bag to apply pressure to the bleeding site. Hold in place for 15 to 20 minutes.
  • Hold a cold compress to the outside of the mouth or cheek in the injured area for 5 to 10 minutes. This will control bleeding and reduce pain.
  • Call your dentist right away for an evaluation; but don’t wait for an appointment if the bleeding doesn’t stop – go the hospital emergency room. Continue to apply pressure on the bleeding site with the gauze until you can be seen and treated.

  

Facial swelling is usually a sign that infection may be present and it is a true dental emergency. An abscessed tooth or other oral infection can become life threatening if left untreated. Call the dentist immediately and use a cold compress (ice or ice-pack wrapped in a cloth) on the area of swelling. Because the cold may helps keep the infection from spreading.

Toothaches have many different causes. They are not necessarily emergencies, but could easily develop into one so call your dentist as soon as possible if your child complains of pain. Over the counter pain medications that are given according to the manufacturer’s instructions may provide some temporary relief but it is important to realize that pain relief from home remedies may be masking a serious underlying problem. Never apply an aspirin or other tablet directly to the painful area because this can cause severe burns to the tissue.

A permanent tooth that is knocked out is a true dental emergency, because the faster the tooth is replaced, the better the chances that the tooth can be saved. Try to find the tooth and rinse it off gently without scrubbing any debris off of it, which can damage the surface. Never use soap or any cleaner for that matter; even mouthwash or toothpaste can be damaging! The ideal place to transport the tooth is in the mouth where it is in contact with saliva, but this may be impractical, especially if the child is likely to swallow it. Place the tooth in cold milk – never water – and get to the dentist’s office (or emergency room) immediately. Permanent teeth that are placed back in the socket within an hour have the best chance of survival.

When a baby tooth is knocked out, contact the dentist as soon as possible. Baby teeth are not reimplanted because here is a potential to damage the permanent tooth developing under it. However, the dentist may feel that it is wise to place a small device to hold the space for the permanent tooth. Furthermore, it is very important to examine the child for any fractures or oral injury that may have resulted from the trauma.

A tooth that is chipped or fractured may be an emergency, especially if the nerve has been exposed. It is a good idea to call the dentist immediately. Rinse the mouth with cool clean water and apply a cold compress to the mouth and lip if it was injured. A fracture leaves the tooth extremely sensitive to temperature change, so avoid placing ice directly on the broken tooth.

Broken braces or wires are fairly common. They seldom represent dental emergencies, but should be addressed as quickly as possible to avoid delays in treatment progress. As always, bleeding or pain is a signal to seek immediate attention. Broken wire or brackets that are irritating the cheeks, lips or tongue, should be covered with a piece of cotton or wax to protect the tissue until the orthodontist repair them. Never try to cut or remove brackets or wires, because doing so creates a risk of swallowing or inhaling these sharp objects.

Lost fillings or crowns are not usually an emergency, but you should call the dentist for an appointment as soon as possible because they can cause sensitivity. More importantly, the newly exposed tooth is particularly vulnerable to decay.

While waiting for your appointment, a loose crown can usually be slipped back over the tooth. Cement it in place using temporary dental cement (available over the counter at the drug store) which will help prevent swallowing it. Cover a lost filling with a piece of cotton gauze to alleviate sensitivity, but severe pain is a signal that there is something else going on that may require more urgent attention.

Of course, it is often said that prevention is the best medicine. Most dental emergencies can be minimized by following a few simple suggestions:

• Schedule regular dental check-ups to prevent or treat cavities early, before they cause an emergency.
• Protective gear, including a mouth guard should always be when children and teens participate in sports, and it is particularly important for children who wear braces. A custom fitted mouth guard made in the dental office provides the best protection and a new one is usually required each season because the child’s jaws are still growing and new teeth may be erupting which changes the fit.
• Always use an age appropriate car restraint – a car seat for young children and seat belts for everyone else.
• Child-proof your home to prevent falls.

When the unavoidable happens, don’t panic. Examine the child’s mouth and teeth as best you can before calling the dentist or doctor, and be prepared to answer some key questions that may be asked of you: Is there any bleeding and can you tell where it is coming from? Are there any broken or shifted teeth? Are they baby teeth or permanent teeth? Does the jaw seem to move normally when opening and closing? Tell the dentist if you are unsure of the answers to these questions so he has as many details as possible when giving a recommendation.

A good rule of thumb for both children and adults is that when in doubt, or when pain, bleeding or facial swelling are present, it is best to seek the advice of the dentist or physician right away. These are usually signs of a problem that is not likely to go away by itself; the right decisions can mean the difference between saving or losing a tooth … or even a life.