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Sensitive teeth can occur for a variety of reasons and in many ways. Sensitivity to temperature, sweets, touch, or pressure are the main types of tooth sensitivity.  The pain and discomfort from sensitive teeth are generally a sign of trauma, tooth decay, or wear, and can range from mildly irritating to quite painful.  Did you know there are effective treatments against sensitive teeth?

Types Of Sensitive Teeth

There are two very different types of sensitivity:

Dentinal Sensitivity. This occurs when the middle layer (dentin) of a tooth is exposed. Dentin is usually covered by enamel above the gum line and by cementum (bone like connective tissue covering the root of a tooth) below the gum line. There are tiny openings called tubules in the dentin. Inside each tubule there is a nerve branch that comes from the tooth’s pulp (the nerve center of the tooth). When the dentin is exposed, these nerve branches can be affected by hot, cold, or certain foods. This causes tooth sensitivity.

When the outer protective layers of enamel or cementum wear away the dentin becomes exposed. This can affect one tooth or multiple teeth. Dentin exposure can be be caused in a variety of ways. These can include:

1. Aggressive brushing. The enamel layer can be worn away from brushing too hard.

2. Plaque build up. The presence of plaque on the root surfaces can cause sensitivity.

3. Tooth wear that occurs over time from clenching and grinding.

4. Untreated dental cavities.

5. Gingival recession. When the gums recede they expose the tooth’s roots. Receding gums are often caused by periodontal diseases or by aggressive brushing. Receded gums are very common and up to four fifths of people have gum recession by the time they are 65.

6. Periodontal surgery (gum surgery) that exposes the tooth’s roots.

7.  Tooth whitening.

8. Frequently eating acidic foods or liquids.

Pulpal sensitivity. This is a reaction of the tooth’s pulp. The pulp consists of a mass of blood vessels and nerves in the center of each tooth. Sensitivity of the pulpal tissue tends to affect only one tooth. Causes of this type of sensitivity can include:

1. Dental cavities or infection.

2. Placement of a recent filling.

3. Excessive pressure from grinding or clenching your teeth.

4. A cracked or broken tooth. If you feel a sharp pain upon biting, you may have a broken or cracked filling. Pain when you release your bite is a sign of a cracked tooth.

Your dentist will be able to diagnose the type of sensitivity you have.

Can Sensitive Teeth Be Strengthened?

Your dentist can strengthen your weakened teeth in two ways. These include the following:

-Attempt to rebuild the worn enamel. Fluoride treatments are highly effective at strengthening weakened tooth enamel. Fluoride contains minerals that can help to strengthen your teeth enamel. Exposing your teeth to more fluoride can be done in several ways:

-In Office Fluoride Treatment. This is the most concentrated fluoride treatment available. During this procedure, trays of fluoride gel, varnish, or foam are placed over your teeth, and allow the fluoride to take effect for several minutes to several weeks.

-At Home Fluoride Treatment. You can also use fluoridated toothpaste, gel, or mouthwash at home for gradual enamel maintenance.

-Create A New Enamel-like Layer. The cosmetic dentistry procedures that are highly effective are dental bonding, crowns, and porcelain veneers.

Dental bonding gives the dentist the ability to add tooth colored material to cover the areas lacking in tooth enamel. This effectively creates a protective layer between the sensitive areas of your teeth and the outside stimulants in the outside world.

Sometimes the sensitivity is related to the tooth nerve suffering from inflammation. This may or may not lead to a need for root canal therapy to stop the pain.

Porcelain veneers and crowns can act as a protective layer and decrease sensitivity or protect a tooth after root canal therapy.

Sensitive Teeth Conclusion

Dealing with sensitive teeth can be very frustrating. Oftentimes sensitivity can be treated effectively and quickly. If you are experiencing sensitive teeth, consult your dentist to see what can be done for you to relieve your discomfort and address problems which may be occurring. The sooner the sensitivity is addressed the less chance of more serious problems.

In today’s modern world, dentistry comes in all forms. How do you know which dentist is right for you and your growing family? There are various specialties in dentistry and many of them overlap between different populations of patients. This overlap is very pronounced between family dentists and pediatric dentists. If you have  children, do you choose a dentist for yourself and a different one for your children?

What Is Family Dentistry?

Family dentists are trained to treat patients of all ages. Family dentists care for your child’s baby teeth, older child’s mixed dentition, adult teeth, and senior dental care. Everyone in the family going to the same dentist can be quite convenient. A child can become easily acclimated to the family dentist by simply watching and modeling another family member. It is usually a very easy transition.

Family dentistry provides preventative dental care, such as regular professional cleanings and oral cancer screenings, and other basic dental care that may be needed. It is important to schedule regular appointments for checkups, so that your dentist can catch any problems before they require the care of a specialist like an oral surgeon or orthodontist. Specialists offer advanced services like treatment of difficult root canals, periodontal surgery, bone surgery, braces, etc. While specialists are still used routinely many of these procedures can be done at the family dental practice. Most dentists will also take x-rays of the teeth on a timely basis to examine for cavities, TMJ problems, diseased tissues, and infection. Your family dentist can fill the cavities, use dental sealants to help to prevent cavities, monitor growth and development to evaluate need for braces, tooth extractions, etc.

If you see your dentist every six months, you will be less likely to have severe breakdown and tooth loss. Your family dentist is trained to help you keep your teeth healthy and can even provide cosmetic dentistry services to keep your smile bright and healthy. Your dentist will educate you and give recommendations for brushing, flossing and rinsing to prevent plaque and tooth decay between appointments. Finding a family dentistry practice that your whole family is comfortable with can take a lot of stress out of making and keeping your regularly scheduled appointments with a variety of dentists.

What Is Pediatric Dentistry?

Where a family dentist will see patients from age 2 to 102, pediatric dentists only see patients from approximately 2 to 18 years old. The pediatric specialty is only related to a young population and does not offer many advanced services of dental care for permanent teeth. Root canals, crowns, impacted teeth, and braces are generally not treated by a pediatric specialist. Many of the services offered do overlap with the family dentist such as x-rays, exams , fillings, sealants, dental cleanings, tooth extractions, baby root canals/crowns, space maintaining appliances. The Pediatric dentists role is important for patients who need specialized care like children with disabilities, those that need sedation, children with severe, full mouth breakdown, and those with behavior issues.

Conclusion

When making the choice between a pediatric dentist and a family dentist, it comes down to you and your child’s comfort levels. Feeling scared or uncomfortable in the exam chair or being scared of the dentist can ruin a child’s confidence and create a situation of dental anxiety or dental phobia. A good dentist, whether family or pediatric, will understand your child’s needs, make the experience a good one, and give great dental treatment. You want a dentist who will  provide a smooth, positive experience so that the little patient is motivated to continue good oral hygiene habits and regular appointments. When she/he is older and has to make health decisions on his/her own, they should have learned to establish a rapport and ease with their dentist. Choose wisely, but realize that a pediatric dentist may or may not be the best choice for your little ones if you have a good family dentist now.

Most family dentists will be happy to see your child even just to meet them and bring them back to get comfortable with the office.If you already have a family dentist that is experienced and willing to take on young children, you may want to start out in this environment to save the the hassle of going between various offices. Selecting a dentist who will treat your child throughout his or her growth has its distinct advantages, and a steady knowledge of patient history is one of them.  Family dentistry is a good choice for many due to the ease of having everyone in the family treated by the same doctor or at least in the same office.

When making any decision for your family it is always best to be informed and have options. There are many dentists with varying personalities, abilities,and skill levels. Find the one that fits you best, and you and your family will be much happier with your choice!



Periodontal disease (or commonly called gum disease) is a very serious and chronic dental infection of the periodontal tissues that can result in the breakdown of the tissue as well as the loss of bone that surrounds and supports your teeth. This dental infection disease begins when bacteria and plaque form a sticky bio film on your teeth and causes inflammation of the periodontal tissue.  Periodontal disease will continue a downward progression if this is not resolved by maintaining proper dental care and hygiene. Periodontal disease is the leading cause of tooth loss in adults. Scientific studies show that somewhere between 75% and 95% of all adults are suffering from some stage of periodontal disease.

Periodontal disease and tooth decay (cavities) are caused by different types of bacteria, and are considered to be two separate and distinct conditions, however, you can suffer from both issues. Poor oral hygiene promotes the risk of both cavities and periodontal disease. Swollen and receding gums open up the more vulnerable areas of the tooth…The root areas, which, are not protected by enamel and can break down quickly to form root decay.  On the flip side, in patients with significant tooth decay, the broken down teeth allow for food trap areas which keep periodontal tissue chronically inflamed.

Gingivitis

Periodontitis

Stages of Periodontal Disease

The earliest stage of periodontal disease is gingivitis (or simply inflammation of the gum tissues). This is the most mild form of periodontal disease. Symptoms include red, swollen (or puffy) and inflamed gums due to plaque-bacteria build-up. The gums may also bleed easily during brushing or eating of hard foods. During the earliest of stages the periodontal disease process it can be reversed thru proper brushing, flossing and professional dental care to remove the excess bacterial plaque. If the required oral hygiene does not occur, the periodontal disease then progresses  to the next stage. The majority of people with this early form of periodontal disease, do not even know a dental problem exists. This is a crucial period for the patient, as the condition can be reversed (since the bone and connective tissue that hold the teeth in place have not yet been adversely affected) at this point if it is recognized, diagnosed, and properly treated by a dental professional. Gingivitis is commonly seen during puberty, pregnancy, times of high stress, and menopause, as raging hormones can make you more prone to inflammation. As for the rest of the population, poor dental hygiene is generally the most common cause, followed by medication and certain medical conditions.

Periodontitis

As the periodontal disease progresses it is now becoming harder to treat and control. The difference between gingivitis and periodontitis is that gingivitis only infects the gum tissue that surrounds the teeth while the periodontal disease process also invades the bone that provides support and stability for the teeth. The bacteria eventually invades past the initial the gum line area and destruction begins to the point that gums may begin to separate or pull away from the teeth (taking away support and connective fibers with it). What results are called periodontal pockets. These pockets allow for bacteria to invade below the gum line.  They eventually become loaded with toxic plaque and bacteria that moves and works its way deeper. It begins to erode the bone below the gum line. A patient’s bite will be affected (as the teeth shift or loosen) by the lost support which then affects chewing and other daily functions.

Advanced Periodontitis

As the periodontal disease process advances further, the fibers and bone that provide support for the teeth are broken down and  destroyed. At least half (50%) of the bone support (if not more) will have broken down at this late stage of periodontal disease. It does not grow back naturally. Teeth may begin to loosen. Deep root cleanings and surgical intervention are typical at this stage. This may include cleaning with a periodontal microscope, (Perioscope), grafting of tissue, bone, placement of growth factors, (Emdogain), periodontal antibiotic regimen (Periostat), placement of antibiotics directly into pockets, (Arestin), open periodontal flap surgery, and, possibly even tooth removal.

How Do I Know If I Have Periodontal Disease?

Periodontal disease can happen to a person of any age. It is most common among adults. Remember, if periodontal disease is detected in its earliest stages it can be reversed so it is important to see your dentist right away if you notice any of the following symptoms:

-Gums that are red, puffy or inflamed, or tender.

Periodontitis

X-Ray showing Periodontal Disease Progression

-Gums that bleed easily during routine brushing or flossing.

-Teeth that appear longer due to recession of gum tissue.

-Changes in the way your teeth fit together when you bite or chew.

-Pus coming from between your teeth and gums

-Bad breath odor or bad taste in your mouth.

Treatment of Periodontal Disease

Periodontal Disease

Arestin use in Periodontal Disease

The earliest stages of periodontal disease are reversible. This is accomplished thru proper brushing, flossing, and maintaining a regular schedule with your dentist. A professional cleaning by your dentist or hygienist is the only way to remove plaque and tartar especially below the gum line. The hygienist will clean (also called scaling) your teeth to remove the tartar and plaque buildup from above and below the gum line. If the periodontal disease condition worsens, then a root planing procedure may be necessary. Root planing helps smooth irregularities on the roots to make it more difficult for plaque to deposit and stick there. Also makes it easier for you to keep your teeth clean at home. Treatment may also include use of antibiotics.

If you have advanced periodontitis, your gum tissue may not respond to nonsurgical treatments and good oral hygiene. In that case, your periodontitis treatment may require dental surgery. This surgical intervention may include:

-Pocket Reduction Surgery (also called Flap surgery). In this procedure, your periodontist makes tiny incisions in your gum so that a section of gum tissue can be lifted back, exposing the roots for more effective scaling and planing. Because periodontitis often causes bone loss, the underlying bone may be recontoured before the gum tissue is sutured back in place. The procedure generally takes from one to three hours and is performed under local anesthesia.

-Soft tissue grafts. Gum tissue is often lost as part of the periodontal disease process making your teeth appear longer than normal. You may need to have damaged tissue replaced to return your cosmetic appearance back to normal. This procedure can help reduce further gum recession, cover exposed roots and give your teeth a more cosmetically pleasing appearance.

-Bone graft. This procedure is needed when periodontitis has destroyed the bone surrounding your tooth. The bone graft helps prevent tooth loss by holding your tooth in place. It also serves as a platform for the regrowth of natural bone.

-Antibiotics and medicaments – A wide array of antibacterial rinses(Peridex), antibiotics taken in pill form, (Periostat) or localized placement directly into the affected pockets(Arestin), can aide in and promote healing of the affected gum tissue.

-Guided tissue regeneration. This allows the regrowth of bone that was destroyed by bacteria. In one approach, your dentist places a special piece of biocompatible fabric between existing bone and your tooth. The material prevents unwanted tissue from entering the healing area, allowing bone to grow back instead.

-Enamel matrix derivative application. Another technique involves the application of a specialized gel to a diseased tooth root. This gel contains the same proteins found in developing tooth enamel and stimulates the growth of healthy bone and tissue. An example of this is the use of emdogain.

To ensure a successful result following periodontal therapy, patient cooperation in maintaining excellent oral hygiene is essential. More frequent professional cleanings can help reduce the likelihood of the periodontal disease ever returning.

By scheduling regular checkups, early stage periodontal disease can be treated before it leads to a much more serious condition. If your periodontal disease is more advanced, treatment in the dental office will be required. Periodontal disease can be managed and controlled for most patients. Following a regular routine of brushing, flossing, and seeing your dentist should be enough for most to keep periodontal disease at bay.

Is the sipping of hot coffee or the eating of cold ice cream sometimes a painful experience for you? If your answer is YES, you may have a common problem called sensitive teeth.

Tooth sensitivity is tooth or teeth discomfort that is provoked by hot, cold, sweet, or acidic foods and drinks, or breathing in cold air. The pain can be sudden, sharp, and shoot deep into the nerve endings of your teeth.

There are two very different types of sensitivity:

Dentinal Sensitivity. This occurs when the middle layer (dentin) of a tooth is exposed to the outside. Dentin is usually covered by enamel above the gum line and by cementum (bone like connective tissue covering the root of a tooth) below the gum line. There are tiny openings called tubules in the dentin. Inside each tubule there is a nerve branch that comes from the tooth’s pulp (the nerve center of the tooth). When the dentin is exposed, these nerve branches can be affected by hot, cold, or certain foods. This causes tooth sensitivity.

When the outer protective layers of enamel or cementum wear away the dentin becomes exposed to the outside. This can affect one tooth or multiple teeth. Dentin exposure can be be caused in a variety of ways. These can include:

1. Aggressive brushing. The enamel layer can be worn away from brushing too hard.

2. Plaque build up. The presence of plaque on the root surfaces can cause sensitivity.

3. Tooth wear that occurs over time from chewing and brushing.

4. Untreated dental cavities.

5. Gingival recession. When the gums recede they expose the tooth’s roots. Receding gums often are caused by periodontal diseases or by aggressive brushing. Receded gums are very common and up to four fifths of people have gum recession by the time they are 65.

6. Periodontal surgery (gum surgery) that exposes the tooth’s roots.

7.  Tooth whitening.

8. Frequently eating acidic foods or liquids.

Pulpal sensitivity. This is a reaction of the tooth’s pulp. The pulp consists of a mass of blood vessels and nerves in the center of each tooth. Sensitivity of the pulpal tissue tends to affect only one tooth. Causes of this type of sensitivity can include:

1. Dental cavities or infection.

2. Placement of a recent filling.

3. Excessive pressure from grinding or clenching your teeth.

4. A cracked or broken tooth.

If you feel a sharp pain upon biting, you may have a broken or cracked filling. Pain when you release your bite is a sign of a cracked tooth.

sensitive teeth

toothpaste for sensitive teeth

You dentist will be able to diagnose the type of sensitivity you have. You want to rule out pulpal sensitivity as that requires more extensive treatment. If it is decided you have dentinal sensitivity then we will suggest a few options for you. The most conservative way is by use of a sensitivity toothpaste. I recommend Colgate Sensitive Pro-Relief which I believe to be the best on the market today. I have found it to be the most effective in eliminating or limiting the symptoms of tooth sensitivity. Other options include use of a fluoride varnish or a bonded desensitizing agent that we would apply in office. As well as use of an at home fluoride rinse.

In severe cases of hypersensitivity that is persistent and cannot be treated by other ways, your dentist may recommend endodontic (root canal therapy) treatment to eliminate the sensitive teeth issue.

If you or a loved one is experiencing either type of sensitivity, the best approach would be to schedule a dental appointment for further evaluation.