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Dry socket (also called medically as alveolar osteitis) is a very painful dental condition that can sometimes happen following removal of a permanent adult tooth. Dry socket occurs when the blood clot at the area of tooth removal fails to develop, or it dislodges or dissolves before the wound has fully healed. Having a tooth removed by your dentist comes with certain expectations. This includes discomfort following the tooth removal. However, this discomfort should last a day or 2 at the most and be fairly mild. Dry socket pain can become very intense quickly and last for almost a week in some cases. Dry socket is actually the most common complication of a tooth extraction. Even with that fact it still only occurs a little less than 2% of the time (about 200,000 cases in US each year) and most often following removal of wisdom teeth. It is also prevalent in those with poor blood flow, smokers, and diabetics. Dry socket generally occurs 2-3 days following tooth removal procedure.

When a tooth is removed, a blood clot forms to protect the opening in your gums as it heals. If the blood clot does not form properly or becomes dislodged, it can create a dry socket. A dry socket leaves the nerves and underlying bones exposed, so it is important to see your dentist immediately. If left untreated, this can lead to dental infection and other complications. Dry socket most often occurs in those  who smoke, are on oral contraceptives (estrogen can interfere with clotting mechanisms), or do not follow post care instructions properly.  Interesting for women, the oral contraceptives also tend to lower pain tolerance which will lead to increased pain sensation if dry socket occurs.

What Is A Dry Socket? Symptoms

Dry Socket Las Vegas Marielaina Perrone DDSSigns and symptoms of dry socket may include:

-Sharp, aching pain usually starting 2-3 days after removal of a tooth or teeth

-Blood Clot Missing. If you peek into your mouth you would see an opening where tooth was and if there is no blood clot present then you probably have a dry socket. In a normal situation a blood clot forms and covers the exposed opening.

-Visible Bone Present. Bone that can be seen upon visual examination in the socket.

-Radiating Pain. Radiating from the tooth socket to your ear, eye, temple or neck on the same side of your face as the tooth removal.

-Abnormally bad breath or a foul odor emanating from your mouth. This will include having a bad taste in your mouth as well.

-Swollen Lymph Nodes. If you have swollen lymph nodes around your jaw or neck, this is a sign of dental infection and you need to be seen by your dentist immediately as this can be a serious medical emergency if untreated. Signs of a dental infection can include fever, swelling, redness, and pus discharge from extraction site.

-Over The Counter Pain Medications Do Not Work. Generally, tylenol, aleve and advil will not be strong enough of a pain reliever to be able to control dry socket pain.

How Can A Dry Socket Be Treated?

Your dentist will relieve the area of pain using a local anesthetic. If the infection has spread this may not relieve all pain and discomfort at this time but it will help. Your dentist will need to inspect the tooth removal site and clean it of any debris or food particles. Once the area is cleaned sufficiently, your dentist will probably place a medicated dressing over the area to promote healing and soothe the dry socket symptoms. These medicated dressings usually need to be changed daily until dry socket symptoms subside. Use of a warm cloth on outside of face can also aid in healing by promoting increased blood flow to the area. If there is infection present or your dentist suspects one is forming an antibiotic may be prescribed. You will also be given detailed instructions on at home care. Usually includes rinsing with warm, salt water and just being careful with area while it heals. Healing of a dry socket at this point will take between 1 and 2 weeks.

Possible Home Help Remedies For Dry Socket

Home remedies to help with dry socket pain can include:
-Rinsing with Warm salt water. Rinsing can help eliminate bacteria and reduce or prevent further infection.
-Cold and heat therapy. This can promote blood flow to area of dry socket. For the first 24 hours or so following a tooth extraction, use cold against your face for 15 minutes at a time to reduce swelling. After 1st day you can use heat in the form of warm cloth to help manage pain.
-Clove oil. This contains eugenol (this is traditional dental office smell), which has anesthetic, anti-inflammatory, and antibacterial properties. It can help to soothe pain and help prevent infections. Some people have reactions to clove oil so speak to your dentist before using. You can place clove oil on a sterile gauze and place it over dry socket area for 15 minutes or so to help relieve dry socket symptoms.
-Honey. Honey has anti-inflammatory and analgesic properties. Clinical studies have found that honey when used for dry socket applications resulted in a significant reduction in inflammation, swelling, pain, and discomfort. There was also evidence honey possibly prevents further dental infection. Honey can be applied similar to the clove oil. Place a small amount of honey on a sterile gauze and place over dry socket wound.
-Black tea. Contains tannic acid. Tannic acid can act as a natural antibacterial agent while also having the ability to reduce both swelling and pain.
-Tea tree oil. Also has antiseptic, antibacterial, and analgesic properties.
-Oregano oil.  Has antibacterial benefits and studies have shown it may even be effective against some drug-resistant strains of bacteria.
-Chamomile tea. Chamomile has anti oxidant properties. This can promote wound healing.

What Is A Dry Socket? Conclusion

It is important to follow your dentist’s instructions especially following a tooth removal. Communicate concerns and questions immediately so they can be addressed immediately to avoid unforeseen complications. A dry socket can be quite painful and can have serious consequences if ignored. See your dentist regularly to maintain a healthy smile for a lifetime.

Wishing Everyone A Happy And Healthy New Year 2020



Tourette syndrome is a a neurological disorder characterized by involuntary motor and vocal tics and often the compulsive utterance of obscenities. This syndrome can be especially hard for self esteem and self confidence. Those suffering from Tourette syndrome can feel isolated and alone. There is no cure for Tourette syndrome but what if your dentist could help relieve these tics? Recent research at Osaka University may give some hope using an oral splint to circumvent these tic events associated with Tourette syndrome.

What Is Tourette Syndrome?

 

Tourette Syndrome Henderson NV Marielaina Perrone DDS

Dr Georges de la Tourette

Tourette syndrome (TS) is a neurological disorder known for its repetitive, stereotyped, involuntary movements and vocalizations referred to as tics. The disorder is named after Dr. Georges Gilles de la Tourette. This French neurologist was the 1st to describe this condition in an 85 yr old French woman. Tourette syndrome is usually first noticed between the ages of 3 and 9 yrs old. Males are afflicted with this syndrome between 3 and 4x more than women. There are about 300,000 Americans with Tourette syndrome. Surprisingly, the syndrome’s tics generally but not always reach their high point in the early teens and tend to improve as we age.

Symptoms Of Tourette Syndrome

The main characteristic of a tourette syndrome patient is one with uncontrolled motor tics as well as involuntary vocalizations. These tourette syndrome tics are classified by the medical community as simple or complex. Simple tics are ones that use a small amount of muscle groups. These include eye blinking, shoulder shrugging, and even facial grimacing. Simple vocalizations will include reptitive throat clearing and grunting sounds. Complex tics are a distinct and coordinated series of movements involving several muscle groups together. An example of a complex motor tic is one in which two movements are combined. This can include a facial grimace in combination with a head twist and shoulder shrug. More complex vocalization tics can include words or phrases vs a simple grunting sound.

These tics are often made worse with increased excitement or anxiety and can be relieved during calm, hyper focused activities. Physical experiences can also trigger or worsen tics. A good example is a neck tie might trigger a neck shrug due to the feeling of the tie around ones neck. Tics do not go away during sleep but are often significantly decreased.

How Does The Dentist Help With Tourette Syndrome?

Traditionally, there is no cure for Tourette Syndrome. There are only interventions which can help alleviate these motor and vocal tics. The medical community has used behavioral methods (like psychotherapy) as well as pharmaceutical ones (like medications that block dopamine in the brain). These medical treatments have not been as successful as hoped. Researchers at Osaka University have tackled the problem thru a study on an oral splint to help alleviate these tics. These researchers developed a custom made oral splint similar to a teeth grinding oral appliance. The custom oral splint is applied over the molars in the back of the mouth. The splint helps to increase occlusal vertical dimension (opens mouth wider than natural). This opening of the jaws changes the alignment of the nose, lips, and chin. The study was published in the scientific journal Movement Disorders.

The research while small (only 22 participants) may be significant. The team found that biting on the custom made oral appliance immediately improved both vocal and motor tics. For the children over 70% saw immediate improvement. For the adults, it was very similar (about 75%). The most fascinating part of this research was that the improvement stayed over the longer haul. Long term improvements after 100 days of use of this oral splint was especially noticeable in patients who were diagnosed at an early age.

It is believed that the custom oral splint helps to act as a sensory trick on the brain. Tourette syndrome patients have long been taught to use sensory tricks to control movements and vocalizations. These have included touching the face or chin when they feel the sensation coming on.

The research team acknowledges larger scale studies will be needed but the oral splint has definite potential for helping hundreds of thousands of people in the US alone.

Tourette Syndrome And Your Dentist Conclusion

Those dealing with the effects of Tourette syndrome know first hand how devastating these tics can be to every day life. They have the ability to affect you socially and in business. A tourette syndrome patient could hopefully see new relief as these studies move further along. For now, your dentist may be able to help by experimenting with you and see what might work best to relieve the Tourette syndrome tics for you.

Thumb sucking can be an all too common habit for many children. It is also an instinctual, natural reflex for many children as a way to soothe themselves. However, over time thumb sucking can be detrimental to a child’s dental and physical development. While it is perfectly natural and healthy when a child is in its infant stages that same habit can become very problematic as they begin to develop teeth and socialize with others.

Is Thumb Sucking Normal?

Yes! It is quite normal. The thumb sucking can occur even in the womb. As infants, children learn about the world thru putting things in their mouths but eventually it becomes a soothing mechanism to make them feel secure and happy and even help them to fall asleep.

Dental Issues From Thumb Sucking

According to the American Academy of Pediatrics treatment for dental problems caused by thumb sucking is generally needed only in children who continue to suck their thumbs past their fifth birthday.

Thumb Sucking Habit marielaina Perrone DDSOnce the permanent teeth begin to erupt and develop in the mouth, the constant thumb sucking may cause dental issues. The common sign is the top teeth push out and upward, and bottom teeth to push inward. This tooth movement due to thumb sucking can cause the following issues:

-Development of a “buck tooth” appearance

-Inability to close the front teeth (open bite)

-Damage to the roof of the mouth

Speech issues

Pacifiers are known to cause similar issues as thumb sucking but the habit of using the pacifier is a far easier habit to break, it can be thrown out, whereas a finger can not. The determining factor if thumb sucking causes dental problems or not, includes the intensity and length of time of the thumb sucking. Checking a child’s thumb for damaged skin and calluses can help determine the severity of the thumb sucking habit. Many children simply rest their thumbs in their mouth and do not actively suck on them. These children are far less likely to develop any long term dental issues from this type of thumb sucking. Aggressive thumb sucking however will have a higher likelihood of developing issues with their primary and permanent teeth if the thumb sucking habit continues.

Speech problems caused by thumb sucking are related to the misaligned teeth, distorted palate, and tongue thrusting. The tongue does not have the ability to find the correct placement for proper enunciation, and the tongue muscle actually needs to be retrained for proper placement of sounds. Tongue thrusting is the pushing forward motion of the tongue when swallowing, causing a continued pressure on the teeth even when not thumb sucking. Speech problems can include not being able to properly say S’s, T’s and D’s, lisping, and tongue thrusting when talking.

Children who are thumb sucking may need treatment include:

-Those who have not stopped thumb sucking on their own by age 4-5.

Speech problems are becoming noticeable due to thumb sucking.

-Peer Pressure – If they are teased or feel embarrassed socially by their thumb sucking.

Tips For Breaking The Thumb Sucking Habit

Breaking a thumb sucking habit will not be easy. The longer your child does it the harder it is to break them of the thumb sucking habit. The following are some tips to help move the process along and break them of their thumb sucking habit.

Communication. Talk to your child about their thumb sucking habit. Explain how it can affect their teeth and kids might make fun of them. Ask how they feel and what you can do to help? Talk about alternative options when the thumb sucking urge comes on.

-Positive reinforcement. This works wonders with children especially of this age. Simple rewards like extra play time or a trip to the park can go a long way to helping break the thumb sucking habit.

Ignore The Issue. Some kids have a thumb sucking problem as an avenue for attention. I would not recommend this as a long term way of breaking thumb sucking habit but it is worth exploring.

-Offer Up An Alternative. Parents should give their child encouragement and offer to do a different activity when they feel the thumb sucking urge coming on. Could be something like squeezing a pillow or hugging their favorite toy.

Speak To Your Dentist. As an authority figure in your child;s life they may have more impact in this area. Your child may listen to them more intently. Your dentist will also offer dental treatment options. These can include:

-Behavioral Therapy.

-Special Nail Polish. This nail polish will be placed over thumb nail and have a foul taste for your child when they go into thumb sucking habit.

-Thumb sucking device that covers thumb. This will physically make it hard to get comfort when thumb sucking.

-Dental Habit Appliance. This is a custom made dental appliance that will make it impossible for your child to continue thumb sucking comfortably.

Thumb Sucking Conclusion

Breaking your child’s thumb sucking habit will take patience and persistence on both your parts. It is a very difficult habit to break especially the longer it is allowed to continue. If you need help call your dentist. Sometimes a group effort is what is needed. Also, be aware that putting too much pressure on yourself or your child can make matters worse. Best to take a calm, methodical approach.