My Blog

By Joseph A. Revak, DMD
May 12, 2020
Category: Dental Procedures
Tags: tooth pain  
ToothPainHereAreSomePossibleCauses

“My tooth hurts…or maybe more than one. Or, it might be my gums.”

If you're having trouble describing the pain in your mouth, don't feel bad. Although our body's pain mechanism is great for alerting us to a problem, it can't always tell us the true cause and location of that problem.

That's especially true of tooth pain. It could be a sign, for instance, of decay within a tooth's inner pulp. When under attack, the nerves in the pulp often send out pain signals that could be sharp, dull, continuous, intermittent, seeming to come from one tooth or several.

If this is the case, depending on how deep the decay is, you could need a filling to resolve the problem or, if it's more extensive, possibly a root canal treatment to save the affected tooth. If you need a root canal, after removing the pulp's diseased tissue, the procedure calls for filling the empty pulp chamber and root canals to prevent future infection.

Another possibility for the pain is gum disease that has also infected the tooth. Gum disease usually begins with the bacteria in dental plaque, a thin biofilm that builds up on tooth surfaces, which infect the gums. If not treated promptly, the infection can advance below the gum line to the tooth roots and supporting bone. From there, it could invade the tooth and travel through the root canals to the interior pulp.

In this scenario, we'll need to treat the gum disease by removing plaque and tartar (hardened plaque) deposits from all tooth and gum surfaces. This is usually done manually with hand instruments or ultrasonic equipment, but it may also require surgical access to infected areas around the roots. If the tooth's nerve has become involved, we may also need to perform a root canal treatment as described above.

There are three key points to take from these two tooth pain scenarios. First, the only way to determine the true cause of your pain (and what treatment you'll need) is with a dental exam. Second, the sooner your pain is diagnosed and you begin treatment, the better your outcome—so see your dentist at the first sign of pain or other symptoms like swollen or bleeding gums.

And finally, you may be able to prevent these and other dental problems by removing disease-causing plaque through daily brushing and flossing and professional teeth cleaning every six months. Prevention through effective oral hygiene may help you avoid a future bout of mysterious tooth pain.

If you would like more information on treating tooth 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 “Confusing Tooth Pain.”

By Joseph A. Revak, DMD
May 02, 2020
Category: Dental Procedures
Tags: tooth decay  
AreLaserstheFutureforTreatingAdvancedToothDecay

Advanced tooth decay is a serious dental problem that can threaten an affected tooth's survival. But for decades now dentists have reliably used root canal treatment to better a decayed tooth's odds. This routine procedure performed with dental drill and special hand tools removes infected tissue inside a tooth and replaces the voids with a filling to prevent future infection.

But now there's a new way to perform a root canal—with a surgical laser. Lasers, amplified and focused light beams, aren't new to healthcare—they're an integral feature of many routine medical treatments and surgeries. But their use is relatively new to dentistry, and to endodontics (treating the interior of teeth) in particular.

Lasers can be used in root canal treatment to perform a number of tasks. They can remove diseased tissue and other debris from the innermost tooth pulp. They can be used to clean and shape root canal walls in preparation for filling. And they can also be used to soften and mold the filling material to fit more precisely within a tooth's particular root canal network.

Although laser-assisted root canal therapy isn't yet widespread, laser's limited use to date has given us a fair picture of both their advantages and disadvantages. As with other medical laser applications, lasers are very precise in removing diseased tissue without too much disruption of healthy tissue. There's less need for anesthesia than with dental drills, and lasers are a lot less noisy and jarring. Patients by and large experience less bleeding, as well as less discomfort or infection afterward.

But because laser light can only travel in a straight line, they're difficult to use in many tightly curved root canals. In these cases, the traditional methods are better suited, although a laser can be used in conjunction with other tasks. Temperature with lasers must also be carefully managed lest the high heat that's often generated damages natural tissues.

Although lasers won't be replacing traditional treatment methods for decayed teeth in the foreseeable future, there's hope they'll become more commonplace as technology and techniques continue to advance. Lasers can only improve what already is an effective means of saving teeth.

If you would like more information on treatments for advanced tooth decay, 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 “Laser-Assisted Root Canal Treatment.”

By Joseph A. Revak, DMD
April 22, 2020
Category: Oral Health
Tags: oral health  
FriendlyBacteriaCanHelpProtectOurMouthsFromDisease

If you know anything about dental disease, then you know bacteria ranks high on the Usual Suspects list. Tooth decay gets its start from acid produced by bacteria; periodontal (gum) disease is often triggered by bacteria that infect the gums.

But the particular strains of bacteria that can cause dental disease are a small percentage of the 10,000-plus species inhabiting your mouth. The rest, numbering in the millions, are fairly benign—and some, as recent research is now showing, play a sizeable role in protecting your teeth and gums against other malicious bacteria, fungi and viruses.

Dr. Aaron Weinberg, a dental researcher at Case Western Reserve University, has been investigating these protective bacteria for many years. His research began with a scientific conundrum: although the mouth has one of the highest densities of bacterial populations, wounds in the mouth tend to heal quickly.

The answer, he believes, originates with human beta defensins (hBDs), substances produced by cells in the lining of the mouth that are natural antibiotics against disease. He has found that certain bacteria actually help stimulate their production.

This isn't just an interesting fact about the body's defenses and immune system. During his research, Dr. Weinberg was able to identify the agent within the bacteria that triggered hBD production. This has opened up a new line of research: The possibility that harnessing this agent might help assist in our treatment of infection by boosting the body's defensive capabilities.

For example, researchers have proposed including a form of the agent in toothpaste. Over time, this might stimulate hBD production and guard the mouth against the development of dental diseases like gum disease.

These possibilities all come from our increasing knowledge and understanding of the microscopic world around us, especially in our mouths. Bacteria are much more complex than we may have realized—not all are our enemies, and some are definitely our friends. Learning more may open up new ways to keep our teeth and gums healthy.

If you would like more information on the mouth's healing abilities, please contact us or schedule an appointment for a consultation.

TooOldtoStraightenYourSmileNotIfYoureLikeTheseA-ListCelebrities

If you're well past your teen years, you probably have several reasons for not straightening your crooked smile: the expense, the time and the embarrassment of being a 30-, 40- or 50+- something wearing braces. But we have five reasons why adult orthodontic treatment can be a smart choice: Tom Cruise, Kathy Bates, Carrie Underwood, Danny Glover and Faith Hill.

That's right: Each of these well-known entertainers and performers—and quite a few more—underwent treatment to improve a poor dental bite. And not as teenage unknowns: Each on our list wore braces or clear aligners as famous adults (the paparazzi don't lie!).

Here are a few of the reasons why these celebrities chose to change their smile through orthodontics—and why you can, too.

Age isn't a factor. Straightening misaligned teeth isn't reserved only for tweens and teens—there are a growing number of adults well into their middle and senior years undergoing orthodontic treatment. As long as your teeth are relatively sound and your gums are healthy, it's altogether appropriate to undergo bite correction at any age.

A boost to your dental health. Gaining a more attractive smile through orthodontics is in some ways an added benefit. The biggest gain by far is the improvement straightening your teeth can bring to your long-term health. Misaligned teeth are more difficult to keep clean of dental plaque, which can increase your disease risk. They also may not function as well as they should while chewing food, which can affect your digestion.

Traditional braces aren't the only way. If the thought of displaying all that hardware makes you cringe, it's not your only option. One of the most popular alternatives is clear aligners, custom plastic trays that are nearly invisible on your teeth—and you can take them out, too. Another method growing in popularity are lingual braces: All the hardware is behind the teeth and thus out of sight. And you can, of course, opt for traditional braces—just ask Tom Cruise!

Oh, yes—a new smile! Orthodontics was truly the first “smile makeover.” It can improve your appearance all by itself, or it can be part of a comprehensive plan to give you an entirely new look. While the gains to your health are primary, don't discount what a more attractive smile could do for you in every area of your life.

The best way to find out if orthodontics will work for you is to visit us for an initial exam and consultation. Just like our A-list celebrities, you may find that orthodontics could be a sound investment in your health and self-confidence.

If you would like more information about orthodontic treatments, please contact us or schedule an appointment. To learn more, read the Dear Doctor magazine articles “Orthodontics for the Older Adult” and “The Magic of Orthodontics: The Original Smile Makeover.”

By Joseph A. Revak, DMD
April 02, 2020
Category: Oral Health
Tags: tooth decay   sugar  
TooMuchSugarCanWreckMoreThanYourTeeth

You've heard it. Your parents heard it—maybe even your grandparents too. Dentists have been alerting people for more than half a century that high sugar consumption contributes to tooth decay.

That message hasn't changed because the facts behind it are the same in the 2020s as they were in the 1950s: The bacteria that cause tooth decay feast on sugar and other leftover carbohydrates in the mouth. This causes them to multiply and increase their production of acid, which softens and erodes tooth enamel.

What has changed though, especially over the last couple of decades, is a growing understanding of how sugar consumption may affect the rest of the body. Just like the evidence of sugar's relationship to tooth decay, current scientific studies are now showing there are strong links between sugar and diseases like diabetes, heart disease and liver disease.

What's startling about what researchers are finding is that cases of these diseases are growing, Especially in younger people. This is a parallel trend to our skyrocketing increases in per capita sugar consumption: the average American now eats the equivalent of 19.5 teaspoons of added sugar every day. Health experts generally agree we should consume no more than 6 teaspoons a day, and children 4.

This is vastly more than we consumed a generation ago. One reason is because processed food manufacturers have increased sugar in their products, hiding under technical, unfamiliar names in ingredient lists. But it's still sugar, and an estimated 74% of processed foods contain some form of it.

But the real surge in sugar has come from our increasing consumption of sodas, as well as energy and sports beverages. These beverages are high in sugar—you can meet your daily allowance with just one 12-oz can of soda. These beverages are now the leading source of sugar in our diets, and, according to experts, a highly dangerous way to consume it.

In effect, dentists of old were on to something: too much sugar is bad for your teeth. It now turns out that it may be bad for your overall health too. Strictly limiting it in your family's diet could help lower your risk of tooth decay and dangerous diseases like diabetes.

If you would like more information on sugar and your health, please contact us or schedule an appointment for a consultation.





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