A toothache can range in severity from infrequent to constant and mild to severe symptoms. If the tooth is sensitive to cold or sweets, it can be a warning that decay is present, a filling has failed, or the tooth is broken. There may be other factors such as sinus infection, referred pain, or sensitive root surfaces.
Pain relievers or toothache preparations, available without prescription, may afford temporary relief from pain. It is important that the tooth not be subjected to hot or cold or the pressure of chewing, and do not place aspirin directly on the gum or tooth. If a tooth is sensitive to heat or tender to the touch, or there is swelling present, serious nerve involvement may be suspect and root canal treatment may be required. One should seek diagnosis as soon as possible.
 

 
Orthodontics is the Dental Specialty concerned with the prevention and correction of facial irregularities and malocclusion, or teeth which fit together improperly. Crooked teeth, usually associated with malocclusion, not only affect cosmetics, but also increase ones susceptibility to tooth decay and gum disease. Improperly aligned teeth can affect speech, impair chewing efficiency and nutrition, and may be the cause of jaw joint problems. Your dentist will refer you to an orthodontist for an examination when necessary. After your case is evaluated you will be scheduled for a consultation regarding the proposed plan, length of treatment, and the cost involved.
 

Today, the term cosmetic dentistry has a different meaning than just the straightening or crowning of teeth. With the development of new materials and techniques, the dentist is able to close spaces, change tooth shape, lighten or darken discolored teeth, and repair chipped or misaligned teeth, without having to sacrifice tooth enamel and sometimes it can be done without anesthetic. The first step is to visit your dentist for an evaluation of your cosmetic needs. He will decide which form of treatment is best suited, whether it be the new bonding and bleaching techniques or the more traditional.
 

Darkened or discolored teeth can be lightened by the application of chemicals. For many years this has been accomplished in the dental office with hydrogen peroxide. Recent advances now allow the bleaching process to be done by the patient at home. The chemical is placed in an appliance which fits over the teeth. The amount of whitening one obtains during bleaching is dependent upon; the length of time the tray is worn, and the susceptibility of the teeth to the bleaching agent.
 

Periodontal disease is responsible for about seventy percent of all tooth loss and it is estimated that ninety percent of adults have some form of this disease. Symptoms can range from mildly inflamed, spongy or bleeding gums to a more serious condition called Periodontitus, involving destruction of the bony support of the teeth. This advanced stage can cause tooth mobility, or tooth loss, and while generally it does not occur until middle age, the initial symptoms can occur much earlier in life. The process is initiated by the presence of plaque, a sticky film that adheres to the teeth, which can harbor bacteria whose toxins are responsible for the infection. If the plaque is not removed, the gums can become inflamed and bleed easily. While there are other causes for bleeding gums, this condition often times is one the early signs of periodontal problems. Controlling plaque by frequent flossing, brushing and visits to the dentist may be adequate for many, but others are more susceptible to the disease and require more intense care. Dentists offer methods of treatment, which not only can prevent this disease, but also can, save teeth from being lost to the advanced stages. Regular visits to your dentist for cleaning and scaling is the first step in maintaining tissue health. The severity of your gum problems will be evaluated and you will be advised how frequent your recall visits should be. More advanced cases may require referral to a specialist.
 

Infected teeth or gums may result in pain and swelling, called a dental abscess. This infection can spread rapidly and should be treated by your dentist as soon as possible. Temporary relief can often be obtained with cold compresses to control the swelling and sometimes antibiotics are prescribed. If the infection is due to a diseased tooth, it can usually be saved with root canal treatment. Nerves, blood and lymph vessels that are in the center of each tooth make up the soft tissue material called the dental pulp. If the pulp becomes diseased, due to injury from a deep cavity, a blow to the tooth, periodontal disease or other cause, it may result in an infection which can spread through the end of the root into the supporting bone and cause an abscess. A root canal is a process in which the necrotic nerve is removed and replaced by a material that seals the root, thus allowing the tooth to be retained. Root canal treatment is preferable to extraction, and it is often less costly, considering the loss of a tooth requires replacement, in order to maintain space and function.
 

A certain amount of swelling and pain is to be expected following any extraction procedure. To minimize swelling and discomfort, an ice pack may be applied to the face and a pain reliever can be taken. Bleeding can often be controlled by placing a gauze pad over the extraction site and applying firm biting pressure for one or two hours, replacing the pad frequently. This procedure may have to be repeated. Excessive swelling, bleeding or pain should be attended by your dentist.
 

When you visit your dentist for an examination, x-rays may be required for proper diagnosis. They are important in detecting tooth decay, periodontal disease, abnormal tooth eruption, fractured teeth, an abscess, or cysts and tumors. Dentists adhere carefully to recommendations published by the American Dental Association, the Academy of Dental Radiology and the National Council on Radiation protection. Because x-rays are taken only when necessary, they present a smaller risk than undetected disease. Measurements have shown that the amount of body radiation in a dental radiographic exam is very small compared to the radiation received from other sources. Patients can help limit exposure levels by requesting a lead apron, keeping records of x-rays taken, and making sure they are forwarded to a new dentist.
 

Although there are many dental diseases, decay and gum infection are the most common. Dental plaque is a thin film that adheres to the teeth, and harbors the bacteria that initiate both of these disease processes. If the plaque is removed with proper brushing, flossing and dental scaling procedures, then decay and periodontal disease can be controlled. Each individual differs in their susceptibility to dental disease, and its presence depends on many factors. Evaluation by your dentist is necessary in order to establish a proper recall frequency for cleaning and scaling, and also to make sure that one maintains oral health with proper brushing and flossing techniques.
 

The urgency and course of treatment for a broken tooth depends upon the severity of the fracture. If it is a small chip and there is no pain it may not require emergency treatment but you should see your dentist as soon as possible. This type of fracture can usually be restored with a filling and until such treatment is rendered one must be careful not to subject the tooth to hot or cold, or chewing forces. If a large portion of the tooth has broken away, but has not affected the nerve, the tooth can most often be restored with a filling or a crown. If the nerve is involved, the tooth usually can be saved with root canal therapy. In the most severe cases when the tooth has been fractured as a result of an accident, there may be tissue swelling, hemorrhage or laceration. Gently clean debris from the injured area. If there is bleeding, apply direct pressure with a clean gauze or cloth, and apply cold compresses to control swelling. Your dentist should be seen immediately.
 

A canker sore is a shallow lesion and should be differentiated from other ulcer-like erosions by your dentist. It characteristically has a yellow border surrounded by a bright red zone, is painful during the first few days, and within 5 to 7 days is covered with a yellowish material. A severe attack may be accompanied by a fever. Over the counter preparations may offer temporary relief, and healing usually occurs within 10 days. Recurrent attacks are common.
 

The joints which connect the lower jaw to the skull and are located in front of the ears on either side of the face are called the tempo-mandibular joints, or TMJ. There are changes which can occur within these joints that result in pain or discomfort. The symptoms can range from headache, earache, tenderness of the jaw muscles, a clicking or popping sound when opening, or a limitation of jaw movement. These abnormalities may be developmental, congenital or sometimes can be caused by fractures, dislocations, tumors or arthritis. Treatment will often include a soft diet, hot-moist packs, medication for pain and a muscle relaxant. A bite plate may be prescribed to prevent clenching or grinding and relieve muscle spasm and joint pressure. The symptoms can worsen if unattended and it is important that one seeks a complete diagnostic exam to determine the cause and effect proper treatment.
 

The normal dentition is comprised of 32 permanent teeth, including 12 molars, 6 on the upper, and 6 on the lower arch. The first permanent molar, commonly referred to as the 6 year molar, is the first to erupt, followed by the second, or 12 year molar. The wisdom teeth, or 3rd molars, normally erupt between the ages of 17 and 21 years, although it is common for them to erupt at a later time.
If these teeth remain trapped below the gums, they can cause pain, tissue irritation, swelling and damage to adjacent teeth or the jaw. The most common indication for extraction in younger patients is lack of eruption space due to jaw size which can result in crowding of the teeth, and malocclusion.
 

Recent advances in implant technology have made implants the treatment of choice for many patients. There are various types of implants, but the most common is a metal post which is inserted into the bone and acts as a root to hold either a crown or an anchor for prosthesis. Dental implant procedures are complex and their success depends on many factors such as good health, whether sufficient bone is present, regular dental visits and an extremely good oral hygiene discipline.
 

Dental care has advanced dramatically in the last few decades. There was a time when tooth loss and replacement with dentures was common, but with today's emphasis on prevention, the use of fluorides, and advanced dental technology, one should be able to keep their teeth for a lifetime. While many patients feel that dentures may be a solution to deteriorating teeth, they are not without problems. The loss of chewing efficiency, facial dimension, muscle tone, and the inability of some patients to feel secure with their dentures are but a few of the many problems dentures can present.
 

One of dentistry's' newer developments in the fight against tooth decay, is a clear plastic material that can be applied to the chewing surfaces of the back teeth and can reduce tooth decay up to eighty percent. The American Dental Association recommends that all children have them applied as soon as possible after tooth eruption. The procedure is low cost, can be done quickly and no anesthetic is necessary. The tooth is simply cleaned, a solution is applied and the sealant is brushed on. Sealants must be checked regularly since they do wear away and need to be re-applied.
 

Fear of dental treatment has prevented many people from seeking necessary dental care. This anxiety may be unwarranted because today dentists' incorporate many new techniques to make treatment more effective, less painful, and generally more caring. More efficient use of employees and equipment allow a maximum amount of work to be done in a minimum amount of time; high speed drills reduce heat and vibration, and topical and local anesthetics have been improved.
When you call for an appointment, request a consultation first so you can discuss any special anxiety problems you may have. A cleaning may be scheduled as one of your first visit, and by the time more extensive work is contemplated, you will be confident of gentle relaxed care.
Remember the benefits of dental treatment far exceed the discomfort, and delay can cause complex and more costly treatment at a later time.