A Cracked Tooth
Some people just love to chew ice. Although it's no worse than crushing candy or other hard edibles with you teeth, it can cause lots of problems. It breaks fillings, chips enamel, and cracks teeth.
A cracked tooth may be sensitive to biting pressure but not necessarily to percussion (tapping). If the crack extends into the pulp chamber, root canal therapy will probably be necessary along with full crown coverage. But a cracked tooth may be tough to find -- even with x-rays. Let's not start thinking root canals and crowns without a thorough examination. Often, the problem is a traumatic bite.
Response of an abscessed tooth to percussion is different from a cracked tooth. Here the sensitivity to tapping is not mild but results in a sharp, acute pain and ache that indicates serious infection of the nerve and inflammation of the membrane at the tip of the root. This condition is not reversible. Sometimes the pain disappears temporarily, but the nerve continues to degenerate.
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Bite Adjustment and Jaw Pain
In many cases, the aches and pains that people experience in their jaws (and related areas) are the result of a bad bite. Often, correcting the bite may be all that is necessary to alleviate the problem.
Dr. Patenaude will examine your bite and see if there is a deflecting surface where your teeth are meeting incorrectly. He may adjust teeth surfaces with high-speed burs or diamond stones. This is called equilibration or bite adjustment. A very fine knowledge of occlusion (how the teeth meet) is needed to recognize any discrepancies in the bite, as they may be very subtle.
Sometimes the bite cannot be corrected by equilibrating because the biting surfaces of the teeth need to be rebuilt. If this is your situation, Dr. Patenaude may recommend onlays or crowns as he restores your bite to a healthy occlusion. Occasionally, orthodontic treatment may be necessary to realign the teeth, and this alone may correct the faulty bite.
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Checking for TMJ Syndrome
Aside from checking the teeth and gums during a routine examination, Dr. Patenaude also examines the joints on each side near the ears. This is to determine whether or not you have temporomandibular joint dysfunction (TMJ Syndrome for short) and whether it requires treatment.
Dr. Patenaude will check for popping or clicking when you open and close your mouth. He will also try to correlate that with any history of pain or limited ability in mouth opening. He will feel the chewing muscles to see if there is any tenderness and ask whether you have many headaches, stiff neck, or problems with the chewing muscled or joints, that you have noticed
Such questions are important, many cases of TMJ pain are related to disharmonies in the bite (the way the teeth meet and chew), but there are a number of other possible causes. Dr. Patenaude will have to put all this information together to know how to treat you if it's needed.
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Comfort Linings
After having your teeth worked on by Dr. Patenaude, do you find that you are sensitive to hot and cold, to chewing, for a long period of time? Well, some peoples' mouths are naturally more sensitive than others. If this is the case with you, perhaps you should ask Dr. Patenaude about comfort linings.
These are linings, usually medicated, which are placed under restorations (fillings) to keep teeth from being sensitive to hot and cold, especially cold. If the restoration is made out of silver amalgam or gold (both metals) it will certainly conduct temperature changes into the tooth. If the restoration is a quartz composite, the chemicals may cause an irritation to the pulp or nerve.
The comfort liner acts as an insulator, cushion and medicated layer, protecting against pressure, chemical irritation, or temperature changes all of which add up to comfort.
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Controlling Dental Fears
Controlling dental fears is important to all of us if we expect to have attractive, healthy teeth which are free of pain. Fear leads to the avoidance of treatment. This neglect will eventually cause problems.
The fact is that modern dental treatment is comfortable and painless. But to know this, both physically and emotionally, it has to be experienced. Routine examinations are the way to build up this acceptance. They afford an opportunity to build up a relationship with Dr. Patenaude and to get acquainted with the office environment and the procedures. Dr. Patenaude is always ready to answer questions and explain dental procedures. Complete and truthful explanations are the only way Dr. Patenaude can get and keep your trust.
People with dental anxiety are often ashamed of the condition of their teeth, and ashamed of their fear as well. Overcoming that fear and getting proper dental treatment will improve your confidence. You'll feel better about your teeth-and about yourself as well.
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Hairline Tooth Fracture
On occasion a seemingly healthy tooth that has never been filled may sustain a hairline fracture through the pain-sensitive pulp. The fracture line may be so fine and in such a position as to defy ready detection, especially since this type of fracture does not show on X-ray films.
When fractured, and for days after the fracture, the tooth can cause the most severe pain ever encountered in dental disorders. The difficulty is that there may be no objective verification of the location of the problem; and pain may or may not be experienced in the fractured tooth (it may be referred to a healthy tooth on the same side).
To be certain, Dr. Patenaude may suggest that treatment be delayed for a few days or more. He is not being cruel, simply cautious. Then the patient must carefully note the features of the pain pattern, as well as time and circumstances. This pattern should ultimately identify the damaged tooth and dictate the proper course of treatment.
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High Spots
High spots on fillings, crowns, fixed bridges, or partial dentures may produce hypersensitivity in teeth because of excessive pressure. The amount of pressure concentrated on these high spots can be enormous, since the muscles used in biting and grinding can produce a force of several hundred pounds!
The teeth may become sore and tender when the jaws are tightly closed or when a person eats, especially if the teeth are subject to temperature changes, even if only a few degrees. Fortunately, this type of pain usually subsides immediately after the excessive pressure is released.
Though Dr. Patenaude makes every effort to restore all parts of the teeth so that they closely match the patient's natural teeth in form and function, occasionally there is a high spot. A patient who has recently had restorative work should not be surprised to need adjustments. What is important is that he or she relate any experience of pain or hypersensitivity to Dr. Patenaude.
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Is it Really Sinus Trouble?
Perhaps you've been experiencing occasional or dull pain in your face or head area and wonder if it may be caused by sinus trouble. This is one of the symptoms of temporomandibular joint syndrome (TMJ); a condition checked by your dentist to see of the problem is caused by TMJ.
TMJ is not a new disease, but new methods of treatment have recently been developed to correct the condition and relieve the pain and discomfort. TMJ can have many causes, among them improperly aligned teeth or malocclusion. It can also be caused by bruxism, the habit of grinding or clenching the teeth. This can cause them to become misaligned and create other dental problems in addition to TMJ.
The pain and aching associated with TMJ will not go away by itself. Ask Dr. Patenaude for an examination to see if you have TMJ syndrome and how the condition should be treated.
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Nitrous-Oxide Analgesia
Maybe you're skittish about going to the dentist. You probably put things off until your really have a problem that can't wait any longer. By then, there may be a lot of discomfort involved.
In this kind of situation, Dr. Patenaude may suggest the use of nitrous-oxide analgesia. Nitrous-oxide is a very mild, general anesthetic gas that is inhaled through a nose piece. Instead of feeling anxious or fearful, the patient feels relaxed. It's lmost like being in a peaceful sleep. The patient has a detached awareness of what is happening but no discomforting sensation. He's given just enough of the analgesia to cover the period of time the dentist needs to complete his work. When he's finished, the patient wakes up as if from a short sleep.
Over-anxious children as well as adults can benefit from nitrous-oxide analgesia because it eliminates the fear of pain, the chief culprit in neglect of dental care. Once you get regular dental care, however, neglect will be eliminated and better dental health will be achieved.
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Noisy Jaw Joints
If you have noisy jaw joints that sometimes click when you open and close your mouth or have been experiencing occasional facial pain or a dull earache, you may have a dental problem. These are symptoms of myiofacial pain dysfuntion syndrome. This problem is associated with the muscles that control the lower jaw or tempermandibular joint.
Aside from chewing food. Consider how often you used your jaw muscles in everyday life. They are always involved when you experience deep emotion or stress, such as grimacing in pain or clenching your teeth. Sometimes this can lead to spasms of the jaw muscles. Another contributing factor is malocclusion or improper meeting of the teeth when your jaws are closed.
Missing teeth, fillings that are too high and teeth that are not properly aligned are some of the dental problems that should be corrected to prevent myofascial pain dysfuntion and other symptoms associated with your temperomandibular joint.
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Oh! My aching jaw!
Have you ever heard someone say, My jaw is killing me! You might even have had the problem yourself. The pain can be excruciating, like a sharp stab, or just an ache. It usually occurs in the area just in front of the ear opening, and is particularly painful on opening or closing. It can hurt so much that the sufferer wants to cry. What is the problem? This type of jaw problem is referred to as the TEMPOROMANDIBULAR JOINT SYNDROME. For simplicitys sake, it is often called TMJ SYNDROME. The strange aspect of this syndrome is that often aches and pains in other parts of the body are also caused by an inflamed or pathologic jaw joint. For example, headaches, earaches, ringing, buzzing, clicking, popping, and scraping noises in the ears, stiff or aching neck or upper back muscles, shoulder pains, and other upper body/neck/head problems have been traced to primary problems in the jaw joint itself.
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Pain in the Jaw
If youve ever experienced a pain in the jaw, you know that it can be severe, almost unbearable, every time you open and close your mouth. Pain in the jaw is sometimes caused by a condition called TMJ syndrome or temperomandibular joint dysfunction. When the temperomandibular joints are thrown out of balance, this causes pressure on bone and muscle that can result in excruciating pain. These joints are located on each side of your head, just in front of your ear openings, and are connected to your lower jaw bone.
One of the unfortunate aspects of TMJ syndrome is that it may also cause referred pain to other parts of your body. Headaches, earaches, ringing, buzzing, clicking, popping, and scraping noises in the ears are sometimes symptoms of TMJ syndrome. So are stiff or aching neck or upper back muscles, shoulder pains, and other discomfort and pain in the upper part of your body.
At first sign of pain the jaw and any other symptoms that may be related to TMJ syndrome, see Dr. Patenaude immediately for treatment.
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Painless Dentistry
Not long ago, toothache or fear of toothache was the most frequent reason for seeking dental treatment. The treatment itself was often not much more pleasant than the toothache.
In recent years, however, significant advances in dentistry have enabled us to treat our patients with little or no discomfort. These advances have been made possible by a better understanding of dental disease and the behavior of diseased mouth tissues, the introduction of better medication and methods of treatment, improvement in traditional dental instruments and equipment, and the invention of new, more efficient devices.
This has started a virtuous (as opposed to vicious) cycle. As more and more patients become comfortable with dental treatment, treatment is sought more promptly, preventive dentistry thrives, and less toothache and discomfort is experience.
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Reasons for Root Cnal
Root canal work (endodontic therapy) is called for when decay or fracture has exposed the tooth pulp (nerve) to bacteria in the mouth. An infection results and pus is generated in the pulp chamber. Left untreated, the infection will spread to the bone around the tooth.
In the beginning there may be little or no pain involved with this condition. It is when the infection reaches the pulp (nerve and blood supply) that the pressure builds and that's when the pain can become severe.
The object of root canal therapy is to clean the tooth completely all the way to the tip (apex), removing the infected pulp. The pulp chamber and canals are then thoroughly cleaned and filled. Usually with gutta percha, If the infected pulp is dead, there should be very little, if any, pain attached to the procedure. However, a certain amount of sensitivity from the bone around the tooth is normal.
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Referred Pain
One of the ways we know we have a dental problem is from a toothache. However, it can be more difficult than one imagines to locate the right tooth. The problem is that pain from the nerves in the tooth pulp may be referred to other teeth on the same side of the mouth. The nerve supply to the tooth pulp contains only pain fibers and does not provide a sense of location.
The absence of position-indicating nerves in the tooth pulp and the ability of pain arising in one tooth to be referred to another tooth on the same side of the mouth, in either the upper or lower jaw, frequently leads a patient to feel pain in a healthy tooth, and not in the tooth that need treatment.
These factors emphasize the importance of clinical and X-ray examination of each patient by Dr. Patenaude. Thorough dental examination is essential to give Dr. Patenaude and patient accurate information with which adequate treatment of diseased teeth can be undertaken.
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Stress and Dental Problems
Stress can affect you in many ways, sometimes leading to dental problems when habits such as grinding the teeth develop. Bruxism, or grinding of the teeth, is usually an unconscious activity, occurring during the night when you're sleeping. The results are often felt in the morning when you feel pain or a dull aching in your jaw joints. This is one of the symptoms of temporomandibular joint syndrome (TMJ), and the problems can intensify until the condition is treated by your dentist.
Many forms of treatment are available, including the use of relaxation drugs as well as exercises. The goal in to help return the jaw to its normal function, eliminating the muscle spasms that cause pain and discomfort. Treatment will also include attention to other dental problems caused by grinding of the teeth.
One of the most common is malocclusion or improperly aligned teeth, which can intensify the pain associated with temporomandibular joint syndrome and cause it to spread to other areas of the head and neck.
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Stress and Dental Problems
Stress can affect you in many ways, sometimes leading to dental problems when habits such as grinding the teeth develop. Bruxism, or grinding of the teeth, is usually an unconscious activity, occurring during the night when youre sleeping. The results are often felt in the morning when you feel pain or a dull aching in your jaw joints. This is one of the symptoms of temporomandibular joint syndrome (TMJ), and the problems can intensify until the condition is treated by Dr. Patenaude.
Many forms of treatment are available, including the use of relaxation drugs as well as exercises. The goal in to help return the jaw to its normal function, eliminating the muscle spasms that cause pain and discomfort. Treatment will also include attention to other dental problems caused by grinding of the teeth.
One of the most common is malocclusion or improperly aligned teeth, which can intensify the pain associated with temporomandibular joint syndrome and cause it to spread to other areas of the head and neck.
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Sudden Wisdom-Tooth Pain
If you have a partially erupted wisdom tooth that suddenly begins causing you pain, you should contact your dentist immediately for help. Percoronitis (infection in the wisdom tooth area) is often caused when food and bacteria are trapped under the gum line. Until a wisdom tooth is fully erupted, it may be difficult to keep it free of food particles, which begin to decay and attract bacteria. Unfortunately, partially erupted wisdom teeth tend to decay easily. When the nerve is also infected this can cause the severe pain of the tooth.
Top help relive the pain until you gets to your dentist, you can rinse your mouth thoroughly with a solution of warm salt water. Usually one teaspoon of salt to a glass of warm water. Normally, aspirin is not recommended to relieve this pain because it may cause bleeding problems if the tooth has to be extracted.
Any pain caused by a wisdom tooth infection is considered a dental emergency and should be treated as soon as possible by Dr. Patenaude.
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Treatment of TMJ syndrome
Many People suffer from problems related to the temporomandibular joint (TMJ)- the joint in front of each ear that controls the opening and closing of the jaw. The symptoms are varied and can include pain, swelling, limited movement of the jaw, muscle spasms, clicking and grinding of the joints, even headaches and stiff neck.
A dentist trained to treat these problems will take a history, conduct a thorough examination and special x-rays to rule out specific joint disease, Then Treatment will begin as indicated.
To break the spasm, muscle relaxants are often recommended. There may be a need for a bite adjustment, and possible treatment appliance may be fabricated to relax the jaw. Muscle injections directly into the joint may also be used. Such conservative treatments, along with efforts to reduce stress, should precede more aggressive forms of treatment.
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Two Types of Anesthesia
Anesthesia, which means loss of sensation, may either be general or local. In general anesthesia the patient is made unconscious by gas that he inhales or by substances introduced into his bloodstream and transported to his brain. For the most part, general anesthesia in dentistry has come to be reserved almost exclusively for serious problems best treated in a hospital. These problems include severely impacted wisdom teeth and fractured jaws, as well as minor treatment in-patients with a dread of dental procedures.
With exceptions such as these, local anesthesia is now the general rule in dental treatment that would otherwise cause pain. Dr. Patenaude chooses an injection site with the smallest number of pain nerves. He slowly injects the local anesthetic since rapid injection would stretch the surrounding tissues and thus inflict pain. After allowing sufficient time for the anesthetic to infiltrate, he is then able to complete his work with little or no discomfort for the patient.
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Wisdom Teeth-Remove or Not Remove?
Wisdom teeth is the name commonly given to the third permanent molars. They lie in the very back of the mouth and, as a result, are often crowded and impact (wedged against at an angle) the tooth in front of them. If they are not impacted, their removal is no more complicated than any other tooth. Sometimes, however, it is important to extract these teeth promptly to avoid complications.
Possible complications of waiting include: pain, swelling, and loss of much of your chewing ability. These things often occur as the tooth attempts to erupt through the gum and creates a flap under which food can become trapped. This decaying food debris becomes an ideal place for bacteria to develop-which is turn leads to infection and its problems which include: prolonged recovery time, increased cost of treatment, and danger to the patient's general health. Most surgical problems from wisdom teeth occur in patients who have waited too long. If extractions are needed, have them done promptly.
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