Posts for: March, 2019
Life would be harrowing if we had no ability to feel pain. Although experiencing it is unpleasant, pain's purpose is to alert us to something wrong in our body. Without pain diseases and other problems could worsen to the point of life-threatening.
But pain without a purpose — the nerves simply misfiring — can make life miserable. This can happen with the trigeminal nerves that exit the brain stem and end on each side of the face. Each nerve has three branches that serve the upper, middle and lower parts of the face and jaw.
When they don't work properly, trigeminal nerves can give rise to a disorder known as trigeminal neuralgia. Beginning often as an occasional twinge, they may escalate to several seconds of mild to excruciating pain occurring over weeks, months or even years. An episode may erupt from chewing, speaking or even lightly touching of the face.
We see this condition most often in people over fifty, particularly women. We don't know the exact cause, but there's strong suspicion that the nerve's protective sheath has been damaged, similar to what occurs with multiple sclerosis or other inflammatory conditions. Another possibility is a blood vessel putting pressure on the nerve and disrupting its normal operation. Such an impinged nerve might transmit pain signals at the slightest stimulation and then fail to “switch off” when the stimulation stops.
Although we can't cure trigeminal neuralgia, we can help you manage it and reduce discomfort during episodes. We'll first try conservative, less-invasive techniques, like signal-blocking medications or drugs that reduce abnormal firing.
If these aren't effective, we may then recommend a surgical solution. One such procedure is known as percutaneous treatment in which we insert a thin needle to selectively damage nerve fibers to prevent their firing. If we've determined an artery or vein has compressed the nerve, we might surgically relocate the vessel. These techniques can be quite effective but they do have possible side effects like numbness or hearing loss.
If you've experienced facial pain, don't continue to suffer. Visit us for a complete examination and learn about your options for pain relief. More than likely, there's a way to reduce your pain and improve your quality of life.
If you would like more information on facial 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 “Trigeminal Neuralgia.”
As the host of America's Funniest Home Videos on ABC TV, Alfonso Ribeiro has witnessed plenty of unintentional physical comedy…or, as he puts it in an interview with Dear Doctor–Dentistry & Oral Health magazine, "When people do stuff and you're like, 'Dude, you just hurt yourself for no reason!'" So when he had his own dental dilemma, Alfonso was determined not to let it turn onto an "epic fail."
The television personality was in his thirties when a painful tooth infection flared up. Instead of ignoring the problem, he took care of it by visiting his dentist, who recommended a root canal procedure. "It's not like you wake up and go, 'Yay, I'm going to have my root canal today!'" he joked. "But once it's done, you couldn't be happier because the pain is gone and you're just smiling because you're no longer in pain!"
Alfonso's experience echoes that of many other people. The root canal procedure is designed to save an infected tooth that otherwise would probably be lost. The infection may start when harmful bacteria from the mouth create a small hole (called a cavity) in the tooth's surface. If left untreated, the decay bacteria continue to eat away at the tooth's structure. Eventually, they can reach the soft pulp tissue, which extends through branching spaces deep inside the tooth called root canals.
Once infection gets a foothold there, it's time for root canal treatment! In this procedure, the area is first numbed; next, a small hole is made in the tooth to give access to the pulp, which contains nerves and blood vessels. The diseased tissue is then carefully removed with tiny instruments, and the canals are disinfected to prevent bacteria from spreading. Finally, the tooth is sealed up to prevent re-infection. Following treatment, a crown (cap) is usually required to restore the tooth's full function and appearance.
Root canal treatment sometimes gets a bad rap from people who are unfamiliar with it, or have come across misinformation on the internet. The truth is, a root canal doesn't cause pain: It relieves pain! The alternatives—having the tooth pulled or leaving the infection untreated—are often much worse.
Having a tooth extracted and replaced can be costly and time consuming…yet a missing tooth that isn't replaced can cause problems for your oral health, nutrition and self-esteem. And an untreated infection doesn't just go away on its own—it continues to smolder in your body, potentially causing serious problems. So if you need a root canal, don't delay!
If you would like additional information on root canal treatment, please contact us or schedule a consultation. You can learn more by reading the Dear Doctor magazine articles “A Step-By-Step Guide to Root Canal Treatment” and “Root Canal Treatment: What You Need to Know.”
A beautiful smile is a balanced smile, especially in regard to your gums. A normal smile usually shows 4 mm or less of gum tissue along with about 10 mm of tooth length. But if your gums show more than that, your smile may seem too gummy. In terms of perceived balance, this could detract from your smile's attractiveness.
Fortunately, you don't have to live with a gummy smile—there are various ways to correct or minimize its effect. First, though, we'll need to determine the underlying cause before deciding on the best treatment. And, there are several possible causes, the obvious being too much gum tissue present. Teeth that appear shorter due to wear or incomplete eruption could also make the gums appear larger.
We may be able to correct these size problems by surgically removing and reshaping excess gum tissues and possibly the underlying bone to reveal more of the teeth. We can also bond composite resins or porcelain veneers to shorter teeth to make them appear larger.
But not all gummy smile problems pertain directly to the teeth and gums; instead, it could be your upper lip moves too far up as you smile (hypermobility). Or, your upper jaw may be too long for your face, which can also cause too much of the gums to show during smiling.
With upper lip hypermobility, we may be able to inhibit the lip muscles' movement temporarily with Botox injections that partially paralyze the muscles (the effect eventually wears off, so this treatment will need to be repeated). A periodontist, an oral surgeon, or a plastic surgeon could also permanently alter the upper lip movement through a surgical procedure. Surgery may also be necessary for an abnormally long upper jaw: orthognathic surgery re-positions the jaw to the skull, which can lessen the amount of gums showing.
If your smile is too gummy, we can transform it. But first, let's find out what the real cause is with a comprehensive dental examination. Once we know, we can better advise you on the best way to bring beautiful balance to your smile.
If you would like more information on improving a gummy smile, 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 “Gummy Smiles.”
Have you ever considered professional whitening as an effective way to brighten your smile? Dr. David Kahn and Dr. John Pergolizzi offer both in-office and at-home teeth whitening in their Ringwood dental practice. Safe, yet powerfully effective, this much sought-after cosmetic service produces stunning results.
Dental stains and you
They happen very frequently. Not only do food, beverages and tobacco contribute to dental stains, age, use and some prescriptions do, too. Additionally, because tooth enamel is hard, but porous, it actually absorbs organic matter much like a concrete sidewalk acquires stains from grass clippings or fall leaves.
Of course, good oral hygiene habits help keep teeth shiny and bright. So do six-month cleanings from your dental hygienist. But, if you look in the mirror and feel dissatisfied with your smile, then ask Dr. Kahn or Dr. Pergolizzi in Ringwood, NJ, if teeth whitening could help your personal appearance and boost your self-confidence.
How teeth whitening works
First, your dentist will examine your teeth and gums to see if they are healthy enough for whitening. You should be free of decay, gum disease and extensive restorative work. If all is well, then you may choose either at-home or in-office whitening.
Either version is safe because it is professionally supervised by your dental team. Either version is effective because it employs highly concentrated hydrogen peroxide gel. Whatever your choice, expect great results--up to eight full shades of color improvement. Dear Doctor magazine states that a good aesthetic goal for your teeth is to match tooth color to the whites of your eyes.
The in-office treatment takes just about one hour. The dentist "paints" on the gel, allows it to penetrate and then rinses it off. The at-home version involves wearing custom-made whitening trays filled with a less concentrated gel. You fill the trays at home and then wear them for the prescribed amount of time daily.
To keep your smile white, be sure to avoid tobacco in all forms, limit coffee, tea and other staining dietary choices, and see Dr. Kahn or Dr. Pergolizzi for your usual check-up and cleaning every six months. The American Dental Association asks everyone to brush their teeth with a non-abrasive toothpaste and soft brush twice a day. Flossing daily to remove interdental plaque is very important as well.
Wow, what a smile!
That's what people will say when they see your newly refreshed smile. To learn more about teeth whitening and other cosmetic dentistry services in Ringwood, contact Dr. David Kahn or Dr. John Pergolizzi and his team for more information or to set up a consultation. Phone (973) 835-3900.