Posts for: October, 2019
Sometimes it's the little things that can be most annoying. Those occasional small sores that pop up on the inside of your mouth are a case in point. Although in most instances they won't last long and aren't anything to be alarmed about, they can still cause you some discomfort.
These small sores are called aphthous ulcers or more commonly “canker sores.” They are breaks in the skin or mucosa, the inner lining of the mouth, and occur most often on the inside cheeks, lips, tongue and occasionally on the soft palate at the back of the throat. They usually appear round with a yellow-gray center and an intensely red outer ring or "halo."
Canker sores often appear during periods of high stress or because of minor trauma, and usually last for a week or two. They often have a tingling pain that can be aggravated when you eat and drink acidic or spicy foods and beverages. About 20 to 25% of people have a form known as recurrent aphthous stomatitis (mouth inflammation) that occurs regularly with multiple sores and heightened pain.
It's possible to manage the discomfort of minor, occasional bouts with a number of over-the-counter products that cover the sore to protect it and boost healing, with some providing a numbing agent for temporary pain relief. For more serious outbreaks we can also prescribe topical steroids in gels or rinses, injections or other medications.
While canker sores don't represent a health danger, there are instances where you should take outbreaks more seriously: if a sore hasn't healed after two weeks; if you've noticed an increase in pain, frequency or duration of outbreaks; or if you're never without a sore. In these cases we may need to biopsy some of the tissue (and possibly run some blood tests) to ensure they're not pre-cancerous or cancerous.
In any event, we can work with you to reduce your symptoms and help the sores heal quickly. This particular “little thing” in life doesn't have to stress you out.
If you would like more information on mouth sores, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Mouth Sores: Understanding and treating canker sores.”
Although techniques and materials have changed, dentists still follow basic principles for treating tooth decay that date from the late 19th Century. And for good reason: They work. These principles first developed by Dr. G.V. Black—the "father of modern dentistry"—are widely credited with saving millions of teeth over the last century.
One of the most important of these treatment protocols is something known as "extension for prevention." In basic terms, it means a dentist removes not only decayed tooth structure but also healthy structure vulnerable to decay. But although effective in saving teeth, practicing this principle can result in loss of otherwise healthy tissue, which can weaken the tooth.
But with new advances in dentistry, decay treatment is getting an overhaul. While Dr. Black's time-tested protocols remain foundational, dentists are finding new ways to preserve more of the tooth structure in a concept known as minimally invasive dentistry (MID).
Better diagnostic tools. Because tooth decay can ultimately infect and damage the tooth's interior, roots and supporting bone, the best way to preserve more of the tooth structure is to treat it as early as possible. Now, new diagnostic tools like digital x-rays, microscopic magnification and optical scanning are helping dentists detect and treat decay earlier, thus reducing how much tissue is removed.
Better prevention methods. Oral hygiene and regular dental care are our basic weapons in the war with tooth decay. In addition, utilizing topical fluoride in combination with a milk-derived product called CPP-ACP dentists can get more of the cavity-fighting organic compound into the tooth enamel to strengthen it against acid attack.
Better treatment techniques. Using air abrasion (a fine particle spray that works like a miniature sandblaster) and lasers, dentists can now remove decayed structure with less harm to healthy tissue than with a traditional dental drill. And new, stronger dental fillings like those made with composite resins require less structural removal to accommodate them.
With these innovative approaches, dentists aren't just saving teeth, they're preserving more of their structure. And that can improve your overall dental health for the long-term.
If you would like more information on minimally invasive dentistry, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Minimally Invasive Dentistry: When Less Care is More.”
If you suffer frequent sinus infections, you might want to talk with your dentist about it. It could be your chronic sinus problems stem from a deeply decayed or infected tooth.
Sinuses are hollow, air-filled spaces in the front of the skull associated with nasal passages. The largest, the maxillary sinuses, are located just behind the cheekbones and above and to the rear of the upper jaw on either side of the face. These sinuses can become painfully congested when infected.
One possible cause for an infection in the maxillary sinus can occur in certain people whose upper back teeth (the molars and premolars) have roots that are close to or even protrude into the sinus. This is normally a minor anatomical feature, unless such a tooth becomes infected.
An infection in teeth with advancing decay or whose nerve tissue has died will eventually reach the root tip through tiny passageways called root canals. If the roots are close to or penetrating the maxillary sinus, the infection could move into the sinus. This is known as Maxillary Sinusitis of Endodontic Origin (MSEO).
A case of MSEO could potentially go on for years with occasional flare-ups of sinus congestion or post-nasal drip. Because of the nature of the infection within the sinus, the affected tooth itself may not show the normal signs of infection like sensitivity or pain. Doctors may attempt to treat the sinus infection with antibiotics, but because the actual source of the infection is within the tooth, this therapy is often ineffective.
If your doctor or dentist suspects MSEO, they may refer you to an endodontist, a specialist in root canals and interior tooth problems. With their advanced diagnostic capabilities, endodontists may have a better chance of accurately diagnosing and locating the source of a tooth-related infection.
As with any non-vital tooth, the likely treatment will be root canal therapy in which the infected tissue within the tooth is removed and the empty spaces filled to prevent future infection. For MSEO, the treatment not only preserves the tooth but may also relieve the infection within the sinus.