Physical pain is unpleasant—but not knowing why you're hurting makes it worse. Thousands of people encounter such as experience when parts of their face suddenly and mysteriously erupt in pain.
Often, though, the mystery can be quickly solved—more than likely, it's a nerve disorder known as trigeminal neuralgia (TN). Typically seen in people over 50 (and in more women than men), TN is a chronic condition that produces brief episodes of acute, spasmodic pain.
The source of this pain is the trigeminal nerve, which courses down each side of the face. Each nerve consists of three distinct branches that serve the upper, middle and lower areas of the face and jaw.
Physicians usually find that a blood vessel has come in contact with the nerve at some point, and the resulting pressure has damaged the nerve's outer insulative layer (myelin sheath). This causes the nerve to become hypersensitive at the point of contact, overreacting in a sense to the slightest touch (even a wisp of wind) on the face and jaw.
TN isn't the only source of facial pain. It can also accompany other conditions like TMD, which is why it's important to undergo a diagnostic examination. If you are diagnosed with TN, there are a number of ways to manage it. The most conservative approach (and the one usually tried first) is the use of medications to block pain signals from the nerve to the brain or to lessen abnormal nerve firing.
If medication proves ineffective or there are other factors related to age and health, you may be a candidate for a surgical solution. In one such procedure, a surgeon inserts a thin needle into the affected nerve and selectively damages some of its fibers to prevent the transmission of pain signals. Another procedure relocates the impinging blood vessel, which then allows the nerve to heal.
These surgical methods are effective but they can cause side-effects in rare cases like numbness or hearing impairment. It's best then to discuss with your doctor which approach would be best for you and your life situation. Ultimately, though, there are ways to relieve you of this painful condition.
If you would like more information on treating 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.”
If you've decided on a dental implant to replace a missing tooth, you've made a great choice. Implants are a big favorite of both dentists and patients, not only for their life-likeness, but also their durability. Studies show that more than 95% of implants survive after ten years.
As you may know, single tooth implants are composed of two main parts: a metal post (usually titanium) imbedded in the jawbone; and a life-like crown affixed to the end of the post. But what you may not know is that there are two ways to attach the crown—either with screws or with dental cement.
Neither way is superior to the other—both have their own set of advantages and disadvantages. A cemented crown, for instance, usually looks more like a natural tooth than a screw-retained crown (more about that later) and dentists have more flexibility in making them look natural.
But cemented crowns require an additional piece of hardware called an abutment to better match it with the implant, something unnecessary with a screw-retained crown. Some people can also experience a reaction to the cement resulting in inflammation or even bone loss. And once installed, removing the crown later for repair or replacement is much more difficult than with a screw-retained crown.
Besides attaching directly to the implant, screw-retained crowns don't require cement and are more easily attached and removed. But the screw-hole can pose some aesthetic problems: Although it can be filled with a tooth-colored filling, the tooth's appearance isn't as ideal as a cemented crown.
So, which one is best for you? That will depend on the type and location of teeth being replaced, as well as your dentist's preferences. For instance, a more attractive cemented crown may be better for a visible front tooth, while a screw-retained crown might be a good choice for a back premolar or molar where appearance isn't as big a factor.
In the end, it's likely your dentist will discuss the pros and cons for each method as it pertains to your individual case. Whichever way your crown attaches, the end result will still be a life-like tooth that could last you for years to come.
If you would like more information on dental implants, 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 “How Crowns Attach to Implants.”
Besides straight and translucent teeth, an attractive smile has another important component: balance. In a great smile, the visible areas of the teeth and gums are in balanced proportion to one another.
But what is the ideal proportion between teeth and gums? Although aesthetic appeal is largely “in the eye of the beholder,” dental professionals typically consider a properly sized tooth to be around 10 mm in visible length. As for the upper gums, no more than 4 mm of tissue should show when smiling. Teeth appearing shorter than 10 mm or the gums displaying more than 4 mm can create an effect called a “gummy smile.”
Fortunately, there are different approaches for correcting a gummy smile, depending on what's causing the appearance of gumminess. Not only are there different causes, but they can be diverse in nature.
Obviously, an actual excess of gum tissue can cause a smile to look gummy—but so can shortened teeth. One possible solution called crown lengthening could help correct either possibility. During the procedure, we remove any excess gum tissue or reposition the gums after reshaping the underlying bone to reveal more of the tooth crown. Worn or shortened teeth can also be made to look longer with porcelain veneers.
A gummy smile could also be caused by a hypermobile lip, in which the lip rises higher than normal while smiling. We may be able to prevent this temporarily by injecting Botox into the lip muscles, which paralyzes them and inhibits their ability to move upward. A more permanent approach is to surgically restrict the upward movement of the lip muscles.
The gums may also seem too prominent if the upper jaw is longer in proportion to the face. One way to correct this is orthognathic surgery, a procedure that moves the upper jaw to a higher position on the skull. This can reduce the jaw profile with the face and subsequently affect how much of the gums show while smiling.
These solutions range from relatively minor to significantly invasive. The first step, though, is to find out what's really behind your gummy smile before taking the next step to make it more attractive.
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.”
Love at first sight—it's an endearing notion found in movies and novels, but perhaps we're a little skeptical about it happening in real life. Then again, maybe it does once in a blue moon. According to supermodel Gisele Bündchen, something definitely happened the first time she met pro quarterback Tom Brady in 2006. And it all began when he smiled.
“The moment I saw him, he smiled and I was like, 'That is the most beautiful, charismatic smile I've ever seen!'” Bündchen said in an article for Vogue magazine. That was all it took. After a three-year romance, they married in 2009 and have been happily so ever since.
Both Brady and Bündchen have great smiles. But they also know even the most naturally attractive smile occasionally needs a little help. Here are three things our happy couple have done to keep their smiles beautiful—and you could do the same.
Teeth whitening. Bündchen is a big proponent of brightening your smile, even endorsing a line of whitening products at one point. And for good reason: This relatively inexpensive and non-invasive procedure can turn a dull, lackluster smile into a dazzling head-turner. A professional whitening can give you the safest, longest-lasting results. We can also fine-tune the whitening solution to give you just the level of brightness you want.
Teeth straightening. When Bündchen noticed one of her teeth out of normal alignment, she underwent orthodontic treatment to straighten her smile. Rather than traditional braces, she opted for clear aligners, removable trays made of translucent plastic. Effective on many types of orthodontic problems, clear aligners can straighten teeth while hardly being noticed by anyone else.
Smile repair. Brady is a frequent client of cosmetic dentistry, sometimes due to his day job. During 2015's Super Bowl XLIX against the Seattle Seahawks, Brady chipped a tooth, ironically from “head-butting” his Patriots teammate Brandon LaFell after the latter caught a touchdown pass. Fortunately, he's had this and other defects repaired—and so can you. We can restore teeth as good as new with composite resin bonding, veneers or crowns.
This superstar couple, known for their advocacy of all things healthy, would also tell you a beautiful smile is a healthy one. You can help maintain your smile's attractiveness with daily brushing and flossing to lower the risk of staining and dental disease, regular dental visits, and “tooth-friendly” eating habits.
And when your teeth need a little extra TLC, see us for a full evaluation. You may not be in the spotlight like this celebrity couple, but you can still have a beautiful smile just like theirs.
If you would like more information on ways to enhance your smile, please contact us or schedule a consultation.
In addition to the usual tooth and gum problems, dentists also see patients with soft tissue infections in and around the mouth. One of the more common of these is the irritation or "cracking" of the corners of the mouth.
Formally known as angular cheilitis (or perleche, a French word, meaning "to lick"), cracked mouth corners are localized irritations made worse by saliva accumulation or an accompanying yeast infection. They're prominent among children and young adults who drool during sleep or while wearing orthodontic braces.
Older adults can also develop cracked mouth corners because of deep wrinkle lines around the mouth ("marionette lines") or tissue irritation from wearing dentures. Teeth loss, especially in the back of the jaws, can weaken facial support leading to collapse of the bite, which can contribute to angular cheilitis.
The condition can cause anything from minor discomfort at the mouth corners to a yeast infection that spreads throughout the mouth and throat. Whatever the symptoms, treatment usually begins with antifungal medication in the form of a mouthrinse or a topical ointment. The dentist may also prescribe a steroid ointment like zinc oxide paste to control inflammation and serve as a barrier against infection.
If the infection has spread beyond the mouth corners, patients may also need to use an antibacterial mouthrinse (usually chlorhexidine) to clear up the infection and help prevent a relapse. Besides cleaning their appliances with chlorhexidine, denture wearers with angular cheilitis should also take their dentures out at night to reduce the chances of a reoccurrence.
Along the same vein, patients who contend with frequent cracked mouth corners and who have missing teeth should have those teeth replaced by some form of restoration. If that involves dentures, it's important to maintain a good fit with them to reduce the chances of tissue irritation. And patients with deep wrinkle lines around their mouth may be able to lessen them through dermatological treatment.
Even though cracked mouth corners rarely pose a major health problem, the discomfort they cause can be a drag on your daily life and activities. Remember that you don't have to suffer—a visit to your dentist could start you on your journey toward relief from this irritating problem.
If you would like more information on angular cheilitis and similar mouth conditions, 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 “Cracked Corners of the Mouth.”
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