CROWNS

Crowns are full coverage restorations that are used to cover a tooth that is likely to break, or is too broken down to be restored with a filling. They are most commonly done after root canal treatment, or when a large filling wears out. The larger the hole made by a cavity that has to be treated, the more likely a crown will be needed. Even after a filling is put in a large cavity, a tooth is more likely to break. Keep in mind that the jaw muscles are the strongest in the human body. Teeth are subjected to tremendous pressures. Crowns ride over the weakened tooth, providing strength and protecting the tooth against breakage. A broken or cracked tooth is a far more serious matter and much more difficult to treat. Crowns prevent this, as well as making for a nice smile.

It takes two appointments to restore a tooth with a crown. In the first any decay is removed from the tooth and it is shaped to accept the crown. Then an impression is made of the tooth for use in fabricating a crown. Between the two visits the crown is made, usually of high-strength porcelain over gold alloy, all ceramic material, or gold. During this time a temporary crown is worn. In the second visit this temporary is removed. Then the permanent crown is adjusted as needed and then cemented in place.

DENTURES

There are different types of dentures, but they share their common function. They replace teeth that have become loose or been lost due to bone loss. When bone loss around the roots of teeth is great enough to loosen them or let them fall out, it’s time for dentures. Relax. No one enjoys losing their natural teeth, but you can still eat and talk regularly.

The entire mouth is examined and a determination is made as to which teeth will have to be removed, and which will remain. The loose teeth are then extracted. Dentures are fitted to go over or around whatever teeth remain in the mouth, depending on the type. There is an adjustment period after dentures are placed in the mouth, and it can take some getting used to. But once accustomed to the dentures, all the normal functionality and appearance return and one just carries on as usual. Often implants can used to further stabilize the dentures.

IMPLANTS

A dental implant is an option to replace a missing tooth. In this procedure, a small titanium shaft is surgically implanted into the bone and allowed to set. The bone grows around it forming a tight connection, which additionally slows or stops the bone loss that occurs when the root of a natural tooth is missing. Once the implant is firmly set in the mouth, the dentist then works to attach the replacement tooth onto the top of the shaft. This permanent solution has the advantages over bridge work that it does not stress the surrounding teeth for support, and, should the tooth wear out, another can simply be replaced on the shaft.

Implants can also be used as support as part of an implant bridge. This is an alternative to partial dentures, and has several advantages. First, there is no adjustment period to acclimatize the patient who, once the work is done, only feels teeth, not metal supports intruding into the mouth. Second, this slows the bone loss occasioned by missing teeth. Third, there is no discomfort or difficulty in eating. And, best of all, of course, they don’t have to be taken out all the time.

We also offer mini dental implants. These implants are about half the diameter of traditional implants are used mainly to stabilize lower dentures. These implants can be placed in one appointment and be immediately used. The cost is 50-70% of standard dental implants. Call for a free consult.

ROOT CANAL TREATMENT

Root canal treatment (also referred to as root canal therapy or endodontic therapy) is made necessary when a cavity is allowed, through neglect, to reach all the way to this pulp. (Regular cleanings and checkups prevent and detect problems early) Sometimes deep restorations or trauma to a tooth may cause the nerve to be damaged to the point it needs root canal therapy, also. Once this occurs the pulp becomes infected, and can even extend through the root tip and begin to eat away at the surrounding bone (this is an abscess). By the time the pulp is infected it must be treated, and cannot heal on its own. It can even weaken the entire immune system. This is dangerous, not to mention very painful. Symptoms that the pulp has become infected may include sensitivity to hot/cold or sweets, pain, swelling, pain to biting or pressure, and a bad taste in the mouth. Sometimes, however, no symptoms are apparent and the person is unaware of any problem until a checkup.

A root canal is then performed to clean out the infected tooth pulp, and disinfect the canals of the tooth. The only other treatment would be to extract the tooth. Once the infection is resolved, the canal(s) are filled in to prevent any further infection. Usually a core build-up and crown is recommended for restoring a tooth that has had root canal therapy.

BRIDGES

This is an option for filling the space created by a missing tooth. It is formed to look like the missing tooth, and it takes its place in the mouth. The sides of a bridge use the two surrounding teeth for support, hence the name. A bridge replaces the missing tooth, both functionally and cosmetically. Bridge work is as much an art as it is an exact science. The materials used may be gold alloys, porcelain bonded to metal alloy, or all ceramic material. The choice of material depends on requirements for strength, wear, and/or esthetics.

It is important that a missing tooth be replaced as soon as possible for several reasons. If not treated the teeth surrounding the gap begin to shift inward, creating a whole chain reaction of bad things. Teeth use their neighbors for support, and, with one missing, they start to “fall.” As this worsens the bite changes in response to the pressure. This can eventually result in problems with the entire jaw, e.g. TMJ. The surrounding teeth deteriorate and it is just a matter of time before they, too, are lost. Gum disease becomes a serious problem, with the difficulty of treatment increasing as the neglect continues.

Most common problem is toothache. i.e mainly pain in one single tooth that may spread sometimes to head, neck or ear areas.

Most of the time two options of treatment is available:

1. save the tooth by doing root canal treatment, followed by (build up recreating lost tooth and having a crown/cap put on it as the tooth becomes like a glass after root canal treatment)
2. extract the tooth- followed by replacement of the tooth as bridge or partial to avoid detrimental effects of lost tooth to the surrounding tooth structures.

These treatment relives pain most of the time. The third option being to not to do anything which is painful and sometimes dangerous/life threatening.

1. If the pain is in one particular tooth- mostly its one tooth problem. If not multiple tooth or gums could be involved.
2. If the pain is sharp and shooting pain: Mostly it happens in a short duration of time and is an acute infection or injury. If the tooth is not broken down badly tooth may be saved by root canal treatment. If not it needs to be extracted especially if its a wisdom tooth or pieces of tooth left.
3. If pain is throbbing and dull aching and wakes you up at night. Mostly the tooth is in process of dying/loosing its nerve sensations. Its a chronic or long standing condition as the pain has been there for months to years. But it is still very painful to go through this. Most of the time you might have had pus /swelling that was on and off  suggestive of a dead tooth or tooth that lost its nerve sensations and might be infected. If there is enough tooth structure left it could be saved by root canal treatment if not it needs to be extracted.

VERY IMPORTANT NOTE: If you are young and if the tooth could be saved its advisable at all cost to save it then to remove it. As removal of a tooth might be a permanent relief of pain but it can lead to damages to other tooth and gums and also any future treatment is expensive and at times can get more complex. You can watch the video below that informs what happens when you loose a tooth over a period of time.

In the meantime till you are able to see the dentist you might consider the following options FOR TEMPORARY RELIEF

Toothache most of the time is due to infection and or inflammation/swelling. Anything that can reduce the infection and swelling can help to relieve the pain. Pain is excruciating most of the time.

1. You might take Motrin or Tylenol extra strength over the counter as needed for pain and may alternate them to get some relief as these medicines act differently to relieve pain.  Taking Motrin and Tylenol alternatively every 6 to 8 hrs as directed by physician has profound effect then taking just one kind.  ( Be considerate of other medical conditions that you might have which can cause side effects of taking the medicine, consult your physician if your are not aware of it)
2. Clove oil or Eugenol oil containing products over the counter (like CVS pharmacy TOOTHACHE) is very soothing for tooth that causes pain. It usually subsides pain significantly and is also a main content for lot of dental treatment medicament.
3. You might want to do salt water rinse/peroxide or Listerine that can keep the area of infected tooth as clean as possible.  Usually infection has acid environment where the bacteria can grow so creating a neutral or basic environment prevents the growth of bacteria.
4. THINGS THAT CAN MAKE PAIN WORSE OR BETTER TO BE AVOIDED:
   • DO NOT SMOKE: Its not a good thing to smoke to relieve the pain. Smoking exaggerates the pain as the heat and smoke to some extent increases swelling of tissues and lets the bacteria grow further.
   • DO NOT PUT HOT PACK: It’s not good to put a hot pack as it might give temporary relief as the tissue is expanding due to heat and moisture and is allowing the infection to grow easily.
   • DO NOT SLEEP ON THE SAME SIDE WHERE THE TOOTH HURTS: as the pressure might help temporarily relieve the pain but it also pushes the infection to spread into the areas where there is less pressure and leading to spread of infection.

I HOPE THIS HELPS SOME OF YOU TO UNDERSTAND THE ISSUES OF PAIN WITH TOOTH.