My Blog
By Michael A. White, DDS
November 24, 2020
Category: Oral Health
Tags: dental care  
AMildNSAIDMayBeAllYouNeedToManageDiscomfortAfterDentalWork

Undergoing dental work is for the most part a pain-free affair. But once you're home and the anesthetic begins to wear off, you may have some discomfort.

Fortunately, most post-procedure pain can be managed with non-steroidal anti-inflammatory drugs or NSAIDs. And while stronger versions of these pain relievers can be prescribed, you may only need one sold over-the-counter.

NSAIDs like ibuprofen or acetaminophen work by inhibiting the release of prostaglandins, substances that stimulate inflammation in traumatized or injured tissues. It differs in this way from the two other primary pain medications: Steroids act like natural hormones that alleviate physical stress in the tissues; and narcotics like morphine or codeine suppress the brain's reaction to nerve firings.

While these stronger types are effective for stopping pain, they can have several serious side effects. Narcotics in particular can be addictive. Although they may be necessary in serious cases of acute pain, most dentists turn to non-addictive NSAIDs first, which are usually effective with the kind of discomfort associated with dental work and with fewer side effects.

That's not to say, however, that NSAIDs are risk-free—they must be taken properly or you could suffer serious health consequences. For one, NSAIDs have a blood-thinning effect that's even more pronounced when taken consistently over a period of weeks. This can lead to bleeding that is difficult to stop and erosion of the stomach lining leading to ulcers. Prolonged use can also damage the kidneys.

As a rule of thumb, adults shouldn't take more than 2400 milligrams of ibuprofen or other NSAIDs in a day, unless otherwise directed by their doctor. For most, a 400-milligram oral dose taken with food (to minimize stomach upset) is usually sufficient to relieve pain for around five hours.

You'll usually avoid unwanted health effects by keeping within your dentist's recommended doses and taking an NSAID for only a few days. Taking an NSAID properly can help keep your discomfort to a minimum after dental work without the need for stronger drugs.

If you would like more information on managing dental 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 “Treating Pain With Ibuprofen.”

By Michael A. White, DDS
November 14, 2020
Category: Oral Health
Tags: tooth pain  
TheKindofToothPainYouHaveMayIdentifytheTrueProblem

Pain can tell you things. Not verbally, of course, as in, “Hey, your appendix is inflamed!” But the quality of your pain—dull or sharp, constant or intermittent, acute or general—can point the way to the actual problem.

That's especially true of tooth pain, which could signal any number of dental problems. Looking at its characteristics, though, can narrow the search. Here are a few examples.

Sharp, momentary pain. This could be an indication of a number of possible dental problems. If it occurs for a few seconds after eating or drinking something hot or cold, it might signal a small area of tooth decay, a loose filling or early signs of gum recession. The latter could be a symptom of periodontal (gum) disease, so you should seek diagnosis and treatment as soon as possible.

Sharp pain when biting. Like tooth sensitivity, this could be a sign of decay or a loose filling, or it could indicate a fractured (cracked) tooth. If it's the latter, you may need an endodontist, a specialist in interior tooth problems, if you want the best chance for saving the tooth.

Dull ache in upper teeth. This might not be a dental problem at all, but radiating pain from an infection of the sinus just above the upper posterior teeth. The infection could also have begun with one of the molar teeth and advanced into the sinus. You'll need to see your dentist for any teeth or gums involved and possibly a physician to address any potential sinus infection.

Constant throbbing pain. That horrible toothache that won't stop could be the nerves in the tooth's interior under attack from decay. The primary means for saving a tooth with deep decay is a root canal treatment to clean out diseased tissue and replace it with a filling or a crown. You should see a dentist even if the pain suddenly subsides—this may only mean the nerves have died, but the infection is still active.

These are just a few of the problems, including true dental emergencies, that oral pain can signal. For any instance of pain in your mouth, see your dentist as soon as possible.

If you would like more information on tooth pain and what it might indicate, 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!

AToothinaDayImplantCouldGiveYouaPerfectSmileFromDayOne

Getting a new implant tooth in only one day sounds too good to be true. But it's true—up to a point. Whether or not you can undergo an immediate crown replacement (attaching a crown to an implant right after surgery) will depend mostly on the underlying bone.

Traditionally, an implant crown isn't attached until several weeks after surgery to allow bone cells to grow and adhere to an implant's titanium surface (osseointegration). The gums are sutured back in place to protect the metal implant until it develops a durable hold within the bone. But this also leaves you with a noticeable missing tooth gap during the integration period.

A “tooth in a day” procedure gives you a full smile right after implant surgery. There is one catch, though—this first crown will be temporary and it won't be able to receive biting pressure.

Until the bone and implant fully integrate, attaching a full-sized permanent crown can damage the implant. To avoid this, the initial crown is slightly shorter than the future permanent crown. This prevents it from contacting solidly with teeth on the other jaw while biting or chewing, which can generate enough force to potentially damage the implant.

If you undergo an immediate-load crown on your implant, you'll have to return later for the full-length permanent crown. In the meantime, though, you'll avoid the embarrassment of a missing tooth in your smile.

With that said, the target bone must be healthy and intact for you to undergo a “tooth in a day” procedure. That isn't always the case with missing teeth—over time, bone volume can gradually diminish. The subsequent loss can complicate implant placement, which must be exact to achieve the most natural outcome. If extensive bone loss exists, you may need grafting to build up enough bone to adequately support an implant.

Even if an implant can be placed, the bone may still be too weak to allow for immediate crown placement. In that case, the traditional procedure may be the best course to allow the bone and implant to fully bond.

To determine if you're a candidate for a “tooth in a day” implant procedure, you'll first need to have a thorough dental exam that includes an assessment of bone health. If it's sound, you may be able to have a full smile right after implant surgery.

If you would like more information on dental implant restorations, 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 “Same-Day Tooth Replacement With Dental Implants.”

By Michael A. White, DDS
October 25, 2020
Category: Dental Procedures
ViggoMortensensRed-CarpetSmile

The Golden Globes ceremony is a night when Hollywood stars shine their brightest. At the recent red-carpet event, leading man Viggo Mortensen had plenty to smile about: Green Book, the movie in which he co-starred, picked up the award for Best Motion Picture—Musical or Comedy. But fans looking at the veteran actor's big smile today might not realize that it once looked very different. A few years ago, an accident during the filming of The Two Towers took a major chip out of Mortensen's front tooth!

That might be OK for some movies (think The Hangover or Dumb and Dumber)—but it's not so great for everyday life. Fortunately, Mortensen visited a dentist promptly, and now his smile is picture-perfect. How was that accomplished? He didn't say…but generally, the best treatment for a chipped tooth depends on how much of the tooth's structure is missing.

If the tooth has only a small chip or crack, it's often possible to restore it via cosmetic bonding. This procedure can be done right in the dental office, frequently in a single visit. Here's how it works: First the tooth is cleaned and prepared, and then a tooth-colored resin is applied to the area being restored. After it is cured (hardened) with a special light, additional layers may be applied to build up the missing structure. When properly cared for, a tooth restored this way can look good for several years.

For a longer-lasting restoration, veneers may be recommended. These are wafer-thin shells made of durable material (most often porcelain) that cover the front (visible) surfaces of teeth. Strong and lifelike, veneers can match the exact color of your natural teeth—or give you the bright, high-wattage smile you've always wanted. No wonder they're so popular in Hollywood! Because veneers are custom-made for you, getting them may require several office visits.

If a chip or crack extends to the inner pulp of the tooth, a root canal procedure will be needed to keep the tooth from becoming infected—a situation that could have serious consequences. But you shouldn't fear a root canal! The procedure generally causes no more discomfort than filling a cavity (though it takes a little longer), and it can help save teeth that would otherwise be lost. After a root canal, a crown (cap) is generally needed to restore the visible part of the tooth.

When a damaged tooth can't be restored, it needs to be extracted (removed) and replaced. Today's best option for tooth replacement is a dental implant—a small, screw-shaped post inserted into the bone of your jaw that anchors a lifelike, fully functional crown. Implants require very little special care and can look great for many years, making them a top choice for tooth replacement

If you have questions about chipped or damaged teeth, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Artistic Repair Of Front Teeth With Composite Resin” and “Porcelain Veneers.”

LingualBracesMightbeaBetterFitforYourActiveLifestyle

If you've decided to straighten your teeth, you've made a wise choice for both your dental health and your smile. Now you may be facing another decision—which method to use for bite correction.

Not too long ago people had only one choice—traditional braces all the way. But that changed with the introduction of clear aligners, a series of removable plastic trays worn one after the other to realign teeth. In all but a few situations, clear aligners accomplish the same outcome as braces but without the conspicuous appearance and, thanks to their removability, difficulty in brushing and flossing teeth.

And now, a recent innovation in orthodontics could give you a third option—lingual braces. These are braces fixed to the back of teeth adjacent to the tongue (hence the term “lingual”), rather than on the front as with traditional braces. They essentially perform the same action, only instead of “pushing” teeth like traditional braces, they “pull” the teeth to the target positions. Lingual braces may also ease certain disadvantages people find with traditional braces or clear aligners.

If you're into martial arts, for instance, you may encounter blows to the face that increase your injury risk while wearing traditional braces. Likewise, if you're highly social, clear aligners can be a hassle to take out and keep up with if you're frequently eating in public. Lingual braces answer both types of issues: They won't damage your lips or gums in the case of blunt force facial contact; and they remain out of sight, out of mind in social situations.

Before considering lingual braces, though, keep in mind that they may cost 15-35 percent more than traditional braces. They also take time for some people to get used to because of how they feel to the tongue. And, they're not yet as widely available as traditional braces, although the number of orthodontists who have received training in the new method is increasing.

If you'd like to know more about lingual braces and whether they're right for you, speak to your dentist or orthodontist. You may find that this new option for improving your dental health and your smile fits your lifestyle.

If you would like more information on lingual braces, 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 “Lingual Braces: A Truly Invisible Way to Straighten Teeth.”





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