What to do for Jaw Pain?!

Today I am all full of information. Maybe it is the spirit of St. Patrick's Day...who knows. I had 2 patients come to me in the past few days with Jaw Pain. Interestingly both are right handed and both had right side pain. One patient had an accident many years ago and the Jaw has Locked open at times ever since. This happened while he was in my chair. The thing to do was and is: remain calm, massage the side of the jaw muscles. Right around the area of the bull's eye in the photo above. After a little time of gentle (GENTLE) effort it closed. Another patient had a stressful week at work and it has been hurting. Her entire masseter muscle was tense to the touch and almost rock hard. With a little massaging we broke the spasm it has been fine since. Stress causes tension, tension and constant clenching of the muscle can result in "Little Charlie Horses" in the joint and masseter muscles of the jaw. A warm towel will help to bring blood to the area and warmth to RELAX that muscle. As some of my prior posts have said, rest (in the form of sleep, muscle rest, etc) is so important.
Hopefully everyone will enjoy. The DAY today.

Why are my Teeth Senstive?

This Monday I will be interviewed by a writer about sensitive teeth. Interestingly enough this month I have had many patients (more than usual) tell me their teeth are sensitive. I am attributing it to the cold snap we have here in New York. It is not just cold air that afflicts the teeth, it can be cold water, sweets, tooth paste, or brushing. To give some background all teeth have pores. These pores are not on the white enamel that we smile with, rather they are right at the border of the tooth and gum. As we abuse our teeth with brushing too hard, grinding our teeth, not flossing, or even not having cleanings often enough our gums can receed. That yellow line you see at the border of the gum and enamel is exposed root. Roots are porous. These pores will go all the way down to the nerve of the tooth. So if something covers these pores, like gum tissue, enamel or calicium (as it should) the tooth is NOT sensitive. If an acidic diet (any drink having Citric Acid), brushing too hard, grinding our teeth, brushing with too strong of a toothpaste (for your mouth) can cause the tooth to be cold sensitive. Cold sensitive to: water, foods, ice, or the COLD New York air. There is a simple solution: cover the pores. This can be done by your dentist by multiple products, or by you at home with Sensodyne ProNamel toothpaste. The paste with Potassium Nitrate "quiets" the nerve of the tooth and soon via Calcium, Fluoride and saliva repair the pores get plugged up. A more "quiet" tooth means a more comfortable tooth. That being said on a tooth that is very sensitive, after brushing and flossing, one could rub a bit of the paste on that sensitive tooth (right at the level of the gum) and let it sit overnight.

Of course more can be wrong with the tooth, the sensitivity could be from a dying nerve and need a root canal, it could be from grinding your teeth, it could be from a crack in the tooth or a cavity, but this is a good start. I have to of course end with the comment "you should seek the advice of your dentist if symptoms persist for more than 2 weeks". That is just good advice no matter who is interviewing you. :)

There is some good information to also review on the Sensodyne website.

http://www.pronamel.us/

Do I need a Root Canal?

The day almost slipped by without my promised weekday entry. Whew.

Having worked on 3 cases of root canal therapy I feel that today we should talk along these lines.

First case was a long standing root canal. This tooth was restored more than 10 years ago. Over time the bacteria that originally caused this problem can slowly grow again. They can hide in accessory canals or have remained from first treatment. It is imperitive for the dentist to CLEAN the canals. It is not just enough to fit a filling material into the tooth, it is PARAMOUNT to clean the inside of the tooth.

The second was a tooth that we had treated and finished today. At times a tooth will be very "HOT" everything will bother it, hot, cold and pressure. This patient had a large cavity but no exposure of the nerve. Over time however

When a patient presents with acute symptoms it is easy to tell that a root canal is needed. However our last case today did not result in a root canal. This patient had pain but no sensitivity to hot or cold (at least nothing out of normal). After viewing his X-ray and finding no infection I proceeded to ask him questions. The tooth did not throb, it did not respond to hot or cold abnormally. It did not hurt when he bit down on a test instrument. It did hurt him in the morning of an appointment to his doctor's office. His concern for that appointment resulted in stress and that caused him to clench his teeth while asleep. A tooth needing root canal will throb and throb with pain. A tooth as this last patient hurt only at times and only when the patient was stressed. This tooth did NOT need a root canal. It needs protection from stress. I suppose going into the weekend should alleviate some stress...from his life and hopefully all of us needing to rest.