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By Randall Furman DDS
February 21, 2020
Category: Oral Health
Tags: tooth pain  
SeeYourDentisttoFindouttheRealCauseforYourToothPain

If you have tooth pain, we want to know about it. No, really—we want to know all about it. Is the pain sharp or dull? Is it emanating from one tooth or more generally? Is it constant, intermittent or only when you bite down?

Dentists ask questions like these because there are multiple causes for tooth pain with different treatment requirements. The more accurate the diagnosis, the quicker and more successful your treatment will be.

Here are 3 different examples of tooth pain, along with their possible causes and treatments.

Tooth sensitivity. If you feel a quick jolt of pain when you eat or drink something hot or cold, it may mean your gums have drawn back (receded) from your teeth to leave more sensitive areas exposed. Gum recession is most often caused by gum disease, which we can treat by removing dental plaque, the main cause for the infection. In mild cases the gums may recover after treatment, but more advanced recession may require grafting surgery.

Dull ache around upper teeth. This type of pain might actually be a sinus problem, not a dental one. The upper back teeth share some of the same nerves as the sinus cavity just above them. See your dentist first to rule out deep decay or a tooth grinding habit putting too much pressure on the teeth. If your dentist rules out an oral cause, you may need to see your family physician to check for a sinus infection.

Constant sharp pain. A throbbing pain seeming to come from one tooth may be a sign the tooth's central pulp layer has become decayed. The resulting infection is attacking the pulp's nerves, which is causing the excruciating pain. Advanced decay of this sort requires a root canal treatment to remove the diseased tissue and fill the empty pulp chamber and root canals to prevent further infection. See your dentist even if the pain stops—the infection may have only killed the nerves, but is still present and advancing.

Pain is the body's warning system—so heed the tooth pain alert and see your dentist as soon as possible. The sooner the problem is identified and treated, the better your chances of returning to full dental health.

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

By Randall Furman DDS
January 12, 2020
Category: Oral Health
Tags: teeth grinding  
TeethGrindingCouldEndangerYourDentalHealth

While your teeth and gums can take a lot, they still face dangers like dental disease. Your teeth are also affected by aging-related wear and tear.

And, something else could put your teeth at risk: teeth grinding. This is an involuntary habit afflicting one in ten adults in which they grind or clench their teeth, often while they’re asleep. This generates higher than normal biting forces that can cause sore jaw joints, accelerated teeth wear and damage to the ligaments that hold teeth in place. In the worst case, you could eventually lose teeth.

So how do you know you’re grinding your teeth, especially if you’re asleep? You might notice your jaw being unusually sore after you wake up or your jaw muscles feel tired. Your dentist may also notice higher than normal tooth wear during a regular checkup. One of the best indicators, though, might be your sleeping partner or family: Teeth gnashing together can be loud enough to disturb others’ sleep.

In treating adult teeth grinding, it’s best to first determine the underlying cause. One of the most prominent reasons is chronic stress: If you’re under high pressure from situations at work or at home, pent-up stress can vent through physical outlets like teeth grinding. You can manage high stress through relaxation techniques, biofeedback or group therapy, which could in turn reduce teeth grinding.

Teeth grinding could also be related to a sleep disorder, such as problems with shifting between nightly sleep cycles. Certain psychoactive drugs are often associated with teeth grinding too. And, because of alterations in brain chemistry, tobacco users are twice as likely to grind their teeth as non-users. So, receiving treatment for a medical condition or making certain lifestyle changes could help lessen a grinding habit.

Many of these approaches take time to alleviate teeth grinding. For immediate relief, your dentist can create a custom mouthguard you wear while you sleep to reduce the effects of teeth grinding. The guard prevents the upper and lower teeth from making contact while biting down, which reduces the forces against them.

The damage from teeth grinding is often cumulative. If diagnosed early, though, we may be able to stop or minimize the damage before it goes too far.

If you would like more information on teeth grinding, 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 “Teeth Grinding.”

By Randall Furman DDS
December 03, 2019
Category: Oral Health
Tags: oral health   pregnancy  
DentalCareDuringPregnancyisSafeandEssential

When a woman learns she's pregnant, her first thought is often to do everything possible to protect the new life inside her. That may mean making lifestyle changes like avoiding alcohol or quitting smoking.

Some women may also become concerned that their regular dental visits could pose a risk to their baby. But both the American Congress of Obstetricians and Gynecologists and the American Dental Association say it's safe for pregnant women to undergo dental exams and cleanings—in fact, they're particularly important during pregnancy.

That's because pregnant women are more susceptible to dental infections, particularly periodontal (gum) disease, because of hormonal changes during pregnancy. The most common, occurring in about 40% of expectant mothers, is a form of gum disease known as pregnancy gingivitis. Women usually encounter this infection that leaves the gums tender, swollen and easy to bleed between the second and eighth month of pregnancy.

Untreated, pregnancy gingivitis could potentially advance below the gum line and infect the roots. It could also have an unhealthy effect on the baby: some studies show women with severe gum disease are more prone to give birth to premature or underweight babies than women with healthy gums.

But it can be stopped effectively, especially if it's treated early. Regular dental checkups and cleanings (at least every six months or more frequently if your dentist recommends) can help an expectant mother stay ahead of a developing gum infection.

With that said, though, your dentist's approach to your care may change somewhat during pregnancy. While there's little concern over essential procedures like gum disease treatment or root canal therapy, elective restorations that are cosmetic in nature might best be postponed until after the baby's birth.

So, if you've just found out you're pregnant, let your dentist know so they can adjust your care depending on your condition and history. And don't be concerned about keeping up your regular dental visits—it's a great thing to do for both you and your baby.

If you would like more information on dental care during pregnancy, 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 “Dental Care During Pregnancy: Maintaining Good Oral Hygiene Is More Important Than Ever.”

By Randall Furman DDS
November 03, 2019
Category: Oral Health
Tags: tmj disorders  
SeekCoordinatedTreatmentIfYouHaveBothTMDandFibromyalgia

Fibromyalgia is a chronic condition that produces widespread pain and stiffness in the muscles and joints. The pain, muscle spasms and tingling it causes can disrupt sleep, alter moods and impair memory function.

Dealing with just this one condition can be overwhelming. But did you know 3 out 4 fibromyalgia patients also develop chronic pain and dysfunction involving their jaw joints? Known collectively as temporomandibular joint disorders (TMD), these jaw joint problems cause pain, muscle spasms and difficulty moving the jaws that can interfere with eating and speaking. TMD can also contribute to headaches and earaches.

Many researchers believe this prevalence of TMD among fibromyalgia patients stems from both conditions originating from the same primary cause—a malfunction within the central nervous system. In both cases, the brain and spinal cord may not be able to process pain signals in a normal fashion. This malfunction could also be generating and amplifying pain signals even when nerves are receiving no stimulation.

For decades now, the most effective treatment strategy for TMD has been to manage the symptoms with physical therapy and exercises, thermal therapy or medications. Relief for fibromyalgia has depended on medication and relaxation techniques like biofeedback therapy. But with the evidence of some connection between the two conditions, it may be helpful to coordinate treatment for both with a team approach involving all your healthcare providers, rather than treat them separately.

To that end, make sure both your dentist or physician treating you for TMD and your physician treating your fibromyalgia each know about the other condition. Consulting together, your healthcare team may find treatments (like certain drugs that counteract neurotransmitter imbalances) that might help reduce symptoms in both conditions. And cognitive-behavioral therapy, meditation and other therapeutic pain management techniques can help you cope with the pain.

Continued research into these two debilitating conditions and the possible links between them may have an effect on how we treat both. A holistic approach to treating them could be the wave of the future.

If you would like more information on the links between TMD and other chronic pain 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 “Fibromyalgia and Temporomandibular Disorders.”

By Randall Furman DDS
September 14, 2019
Category: Oral Health
Tags: tmj disorders   jaw pain  
TwoMouthandFacePainDisordersandWhatYouCanDoAboutThem

Chronic pain affects the quality of life for an estimated 50 million adults in the U.S. alone. The American Chronic Pain Association designates September as “Pain Awareness Month” to highlight the many conditions that cause chronic pain and strategies to manage them. Among these are conditions that can involve your oral or facial health. Here are two painful mouth and face disorders and what you can do about them.

Temporomandibular Joint Disorder (TMD). TMD is a common condition often seen in the dental office. The temporomandibular joints connect the lower jaw to the skull and facilitate activities like eating or speaking that require jaw movement. If they and their associated muscles become inflamed, this can trigger debilitating chronic pain. If you suffer from TMD symptoms, make sure we know about it so we can make your dental visits as comfortable as possible.

When possible, avoid irreversible and invasive treatments for TMD that may permanently change your bite, such as surgery or having teeth ground down. Instead, most healthcare professionals recommend a more conservative approach. Try the following tips to alleviate TMD pain:

  • Eat soft foods so you do not aggravate the jaw joint.
  • Avoid extreme jaw movements like suddenly opening your mouth very wide.
  • Use ice packs and moist heat to relieve discomfort.
  • Ask us about jaw exercises to stretch and relax the jaw.
  • Practice stress-reduction techniques, such as meditation, yoga, tai chi or taking short walks to clear your mind.

Burning Mouth Syndrome. The sensation that the mouth has been burned or scalded without an obvious cause is most common among women during menopause. While researchers can’t yet pinpoint clear causes for it, the list of suspects includes hormonal changes, neurological or rare autoimmune disorders or medication-induced dry mouth.

The first step to treatment is an oral exam along with a complete medical history to identify any possible contributing factors. Depending on the results, we can offer recommendations to manage your symptoms. The following tips often help:

  • Keep your mouth moist. We can recommend an artificial saliva product or medication to increase saliva flow if needed.
  • Change your toothpaste if it contains irritating ingredients.
  • Identify and avoid foods and beverages that seem to precede an episode. These may include spicy foods, coffee and alcoholic beverages.
  • Quit smoking, as this is often linked to burning mouth episodes.

The pain and discomfort caused by these and other oral conditions can put a dent in your life. A visit to your dentist, though, could be the first step to finding relief.

If you would like more information about oral conditions that produce chronic pain, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Seeking Relief From TMD” and “Burning Mouth Syndrome.”