Bay Area Smiles - Health Library

What Are Sensitive Teeth?

Teeth are sensitive if they often hurt when they are exposed to cold or to air. You may also feel discomfort or a sudden flash of pain when eating sweet, acidic, or hot foods. The pain you feel may be due to receding gums, worn tooth enamel, or worn root surfaces. Healthy teeth are protected by strong enamel and good gums.

How Teeth Become Sensitive
When enamel erodes or gums recede, dentin can be exposed. Dentin is the layer of the tooth that is normally covered by the enamel and gums. The most common cause of sensitive teeth is exposed dentin. Dentin is connected to the nerve that triggers pain in sensitive teeth.

If You Have Sensitive Teeth
See your dentist if you have sensitive, painful teeth. Your dentist will examine your teeth, determine the cause of your tooth sensitivity, and recommend a proper treatment plan.

Understanding Bruxism (Teeth Grinding)

Although teeth grinding (bruxism) may happen at any time, people often grind their teeth in their sleep. You may not even know you're doing it. The causes are not clear. Stress is one possible cause, but often the reason for the habit is not known.

Damage Caused by Teeth Grinding
Teeth grinding may cause:

  • Chipped enamel and cracked teeth
  • Flattened, grooved, worn-down teeth
  • Loosened teeth
  • Periodontal (gum) problems

If it goes untreated, bruxism may lead to jaw muscle and joint problems and even loss of your teeth.

Evaluating the Problem
Your dentist will examine your entire mouth and ask several questions. This evaluation helps confirm that you do grind your teeth. It may also help identify a possible cause of your teeth-grinding habit.

The Symptoms of Grinding
Symptoms like these may be a signal that you grind your teeth:

  • A sore, tired jaw
  • Sensitive teeth
  • Loose teeth
  • Dull headaches, earaches, or neck aches
  • Clicking sounds when you open your mouth

Possible Treatments
Your dentist may suggest one or more of these treatments:

  • A mouth guard (plastic device that fits over your teeth) protects teeth from grinding damage. It's worn at the times when you're most likely to grind your teeth.
  • Bite adjustment (correcting the way your top teeth fit against your bottom teeth) can reduce chances of grinding if your bite is uneven.
  • Reducing stress may lessen grinding by relaxing your jaw muscles. Your dentist may suggest ways to reduce stress, like exercise.
  • Medication may be given to help relieve sore muscles or reduce stress.

 

Dental Trauma

Injury to the teeth or mouth can happen due to an accident or sports injury. Dental trauma may not always seem serious. But even minor injuries can cause infection or other problems. The key to saving your smile is getting help right away.

When to Go to the Emergency Room (ER)
Speed is crucial when it comes to most tooth trauma. The faster you're treated, the better the chances your tooth or teeth can be saved. Go to your dentist or the ER at once if:

  • You break one or more teeth.
  • You have one or more teeth knocked out (put the tooth in a glass of cold milk and bring it with you).
  • A cut on your lip or tongue won't stop bleeding.

What to Expect in the ER
Your injury will be examined. If you've lost a tooth, a dentist may be able to replant it. For the best results, this is done within an hour after your injury. In some cases, a broken tooth can also be repaired. Cuts and abrasions may be treated with cold packs and dressings.

Follow-up
Once you're home, call your dentist right away if you:

  • Develop a fever over 101°F .
  • Have drainage from around a repaired tooth.
  • Have pain that worsens after 24 hours.

Steps to Saving a Permanent Tooth
If a permanent tooth is knocked out:

  • Handle the tooth by the top, not the roots.
  • Keep the tooth in a glass of milk or saltwater (dissolve 1/4 teaspoon salt in 1 quart of water). This keeps the tooth from drying out.
  • Get medical help right away.

 

Understanding Temporomandibular Disorders (TMD)

Do you have pain in your face, jaw, or teeth? Do you have trouble chewing? Does your jaw make clicking or popping noises? These symptoms can be caused by temporomandibular disorders (TMD). This term describes a group of problems related to the temporomandibular joint (TMJ) and nearby muscles. Your symptoms may be painful and frustrating. But don't worry. Your healthcare team can help you treat TMD and prevent future problems.

What's Wrong?

TMD causes many kinds of symptoms. That's part of the reason it can be hard to diagnose. You may have headaches, tooth pain, or muscle aches. Your pain may be constant. Or it may come and go without any apparent reason. TMD-related problems include:

  • Tight muscles
  • Joint inflammation
  • Joint damage
  • Teeth grinding or clenching

What Can You Do?
If you are having TMD symptoms, don't wait. Call your dentist or primary care doctor right away. You don't have to live with pain or discomfort. TMD can be treated. In fact, a key part of treatment is learning to manage your condition at home.

Which Treatment Is Right for You?
Treatment helps rest the muscles and joint. It also helps relieve symptoms and restore function. Depending on the type of problem you have, your treatment plan may include:

  • Temporary diet changes.
  • New habits for managing stress and maintaining the health of your jaw.
  • Medication to reduce pain and inflammation.
  • Therapy to reduce pressure on the joint and restore function.
  • Dental treatment to reduce pressure on the joint.

How Can You Avoid Future Problems?
Treatment can help relieve your current condition. But TMD symptoms may return over time. You can avoid future problems by maintaining the health of your jaw:

  • Avoid foods and habits that make your symptoms worse.
  • Lower the stress level in your life.
  • Follow your treatment plan.
  • Pay attention to your body and get help if symptoms recur.

 

Understanding Tooth Decay

Plaque is a sticky coating of bacteria and other substances that forms on your teeth and gums. It can cause two serious problems: tooth decay and gum disease. These problems damage the teeth and gums, and may even lead to tooth loss. When the mouth is well cared for, tooth decay and gum disease can be reversed in their early stages. Better yet, you can prevent these problems from starting by brushing and flossing daily.

How Tooth Decay Develops
Tooth decay happens when acid eats away at a tooth. Cavities (also called caries) are holes that form in the teeth. They are most common in places that are hard to reach with a toothbrush. This includes the grooves at the tops of the teeth, and on the sides where the teeth touch. In late stages, tooth decay can be painful. It can also lead to tooth loss.

Treating Tooth Decay
Tooth decay can be treated to keep it from moving farther into the tooth. This is often done by filling cavities. First, any tooth decay is removed. This protects the tooth from further damage. Then, the cavity is filled with a hard material. This filling protects the damaged tooth and restores the tooth surface. If the tooth is severely damaged by decay, other treatments are available.

Follow-up Visits
Visit your dental team at least every 6 months for a checkup and cleaning. If you're being treated for tooth decay or gum disease, you may need more frequent visits. These visits will likely decrease as your mouth care efforts start to pay off. Keep flossing and brushing, and follow any special instructions your dentist or dental hygienist gives you. And enjoy flashing your healthy smile!

Understanding Impacted Wisdom Teeth

Wisdom teeth that cannot fully break through the gum (erupt) are called impacted. These teeth can grow in almost any direction, including:

  • Straight upward (vertical position), but without room to erupt into a healthy position.
  • Angled away from the other teeth (distoangular position).
  • Parallel to the gumline (horizontal position).
  • Angled in toward the other teeth (mesioangular position).

Problems Caused by Impacted Teeth
Impacted wisdom teeth can cause acute (sudden) problems, chronic (ongoing) problems, or no problems at all. Removing the teeth before symptoms develop can prevent or reduce future complications. Dental x-rays can help your dentist find existing problems. X-rays may also help show whether your wisdom teeth are likely to cause problems in the future. But it's not always clear whether your wisdom teeth will give you trouble. Potential problems include:

  • Acute pericoronitis (gum infection). As the tooth breaks through the gum, the gum can become infected, causing pain, swelling, and sometimes bleeding.
  • Chronic periodontal (gum) disease. Problems flossing at the back of the mouth can lead to gum disease. Or it may result if bacteria and food debris collect under the gum tissue covering an impacted tooth. Gum disease can lead to loss of the adjacent molar.
  • Tooth decay. Wisdom teeth can be hard to clean because they're at the back of the mouth. This can lead to decay of both the wisdom tooth and the tooth next to it.
  • Crowding. An impacted tooth can push on nearby teeth, forcing them out of alignment. This can interfere with your bite. Crowding can also damage individual teeth.
  • Poorposition. A tooth that grows pointing in toward the tongue or out toward the cheek can irritate nearby tissue. It may interfere with your bite. Problems can also occur if there is no corresponding tooth in the opposite jaw for the tooth to bite on.
  • Cysts and tumors. A tooth that's embedded in the bone is encased in a sac. This sac can fill with fluid, forming a cyst. A cyst can expand and destroy surrounding bone. In rare cases, a tumor forms in this area.

 

Understanding Orthognathic Anatomy and Problems

A jaw that's too small, too large, or crooked can cause problems with chewing, speaking, breathing, and even sleeping. The shape of your jaws also affects the way your face looks. This sheet helps you understand how the teeth and jaws work. It also describes common jaw problems that may need treatment.

How Bones and Teeth Shape the Face
Bones are the framework for the face. The size and position of facial bones determine how well the teeth fit together. Together, the positions of the jaws and teeth affect chewing, speaking, and the working of the jaw joint. The jaws also hold and support soft tissues, such as the muscles, lips, and tongue. And of course the jaws and teeth are factors in the face's shape and appearance.

How the Jaws Work
The lower jaw holds the tongue, which moves freely as you speak and eat. The upper jaw shapes the floor of the nasal cavity, allowing normal airflow. Normally, muscles are evenly developed on both sides of the face.

Common Problems
Some common jaw alignment problems are described below. It's also common to have a combination of these problems.

  • Lower jaw too far back: When the lower jaw is too far back (retrognathia), biting can be difficult. The chin appears weak or receding.
  • Lower jaw too far forward: A lower jaw that is too far forward (prognathia) causes the chin to protrude. Lower teeth may jut outward to overlap the upper teeth.
  • Open bite (teeth don't meet): An open bite is often due to a long upper jaw. This can cause a "gummy smile." Or the problem may be that the rear of the lower jaw is too short. An open bite can make it impossible to close the lips.
  • Asymmetry (jaws are uneven): Uneven jaws are larger or smaller on one side than on the other. Or one side may be too far forward or back. The face may look off-center or crooked.

When Jaws Are Not Aligned
Poorly aligned jaws can result in a variety of problems, including:

  • Chewing problems: You may find it difficult to bite into a sandwich or an apple, or difficult to keep food in your mouth as you chew. The TMJs may be stiff or painful.
  • Speech problems: It may be difficult to make certain sounds or to speak clearly.
  • Breathing problems: If the airway is narrow or blocked, breathing may be noisy or difficult. You may have sleep apnea (breathing that stops during sleep).
  • Problems with appearance: You may be unhappy with the way you look. This can make you self-conscious and may affect your confidence.