Gary A. Franz, D.D.S.

Chronic facial pain is a problem faced by millions of Americans.

Common symptoms can include pain in or around the ear, tenderness of the jaw, clicking or popping noises when opening the mouth or even head and neck aches.

If you are suffering from this type of pain, your dentist can help identify its source with a thorough exam and appropriate x-rays.

Sometimes, the problem is a sinus or toothache or it could be an early stage of periodontal disease.

But for some pain, the cause is not so easily diagnosed.

There are two joints and several jaw muscles which make it possible to open and close the mouth. They work together when you chew, speak, and swallow.

These structures include muscles and ligaments, as well as the jaw bone, the mandible (lower jaw) with two joints, the TMJ�s.

Any problem that prevents this complex system of muscles, ligaments, discs and bones from working together properly may result in a painful TMJ disorder.

There are several ways the TMJ disorders may be treated.

Diagnosis is an important step before treatment.

Part of your clinical examination includes checking the joints and muscles for tenderness, clicking, popping or difficulty moving.

Your dentist may take x-rays and may make a �cast� of your teeth to see how your bite fits together.

To help you deal with this pain, your dentist will recommend what type of treatment you need and may refer you to a specialist.

Everybody wants the best smile possible and there’s no need to have it spoiled by gaps in your teeth or by teeth that are stained or badly shaped.

Whether the problem was caused by nature or by an injury, you may be able to have a veneer placed on top of your teeth to restore or improve your smile.

Veneers are thin, custom-made shells crafted from tooth-colored materials designed to cover the front side of teeth.

Your dentist will usually make a model of your teeth and the veneers will be made by a specialist dental technician.

A small amount of enamel has to be removed from your teeth to accommodate the shell so having veneers is usually an irreversible process.

In order to make the most of your veneer, your dentist may suggest that you avoid foods and drinks that could discolor them, such as coffee, tea or red wine.

It’s also possible that veneers might chip or fracture.

But, for many people, veneers are well worth it as they give them a completely new smile.

When you put food in your mouth, it immediately meets the bacteria that live there.

Plaque, for example, is a sticky film of bacteria.

These bacteria love the sugars found in many foods. So, when you don’t clean your teeth after eating, the bacteria and the sugar can combine to produce acids which can destroy the enamel – the hard surface of the tooth.

In time, this can lead to tooth decay. The more often you eat and the longer foods are in your mouth, the more damage occurs.

Many foods that are nutritious and important in our diet contain sugars – such as fruits, milk, bread, cereals and even vegetables.

So the key is not to try and avoid sugar but to think before you eat.

When you eat is also important because each time you eat food that contains sugars, the teeth are attacked by acids for 20 minutes or more.

This means that foods that are eaten as part of a meal cause less harm. More saliva is released during a meal, helping to wash foods from the mouth and reduce the effects of acids.

Here are some tips to follow when choosing your meals and snacks.
– Eat a variety of foods from different food groups
– Limit the number of snacks that you eat
– If you do snack, choose nutritious foods, such as cheese, raw vegetables, plain yogurt, or a piece of fruit

Its also important to brush your teeth twice a day and to clean between your teeth daily with floss or interdental cleaners.

And of course regular visits to your dentist will help prevent problems from occurring and catch those that do occur while they are easier to treat.

Dental implants are increasingly popular as a way to replace missing or damaged teeth.

Their great advantage is that they look natural and feel secure helping you to restore your smile and eat more easily.

Implants are an ideal solution for many people but they are not an option for everyone.

Placing implants requires some surgery so patients must be in good health, have healthy gums and have adequate bone to support the implant.

They must also be committed to taking action to maintain their oral hygiene and to visiting the dentist regularly.

The process for placing implants is as follows:

First, surgery is performed to place the anchor. This can take up to several hours. Following the surgery, you may need to wait up to six months for the bone to grow around the anchor and firmly hold it in place. Sometimes follow up surgery is required to attach a post to connect the anchor to the replacement teeth. Alternatively, the anchor and post may already be attached and are placed at the same time.

After the gums have had several weeks to heal, the next step is to fit specially-made artificial teeth to the post portion of the anchor. This can take a few weeks to complete as several fittings may be required.

Implant surgery can be done either in a dental office or in a hospital, depending upon a number of factors. A local or general anesthetic may be used. Usually pain medications and, when necessary, antibiotics are prescribed.

After your implants are fitted, your dentist will give you tips and advice on maintaining your oral hygiene.

Your dentist can help you decide whether you would be a good candidate for implants.

Your smile is a major factor in the impression people get when they meet you.

And the good news is that you now don’t have to settle for a smile spoiled by stained, chipped, or misshapen teeth.

Advances in dental treatment mean there is a wide range of choices to help you get the smile that you want. Here are some of the options:
– Tooth whitening (bleaching) can help brighten teeth that have become discolored or stained. It can be done in the dental office or with a system the dentist can give you to use at home
– Bonding improves the appearance of teeth that have become chipped, broken, cracked or stained. This is done by bonding tooth-colored materials to the tooth surface
– Enamel shaping involves modifying teeth to improve their appearance by removing or contouring enamel
– Veneers are thin custom-made shells of tooth-colored materials designed to cover the front side of teeth. They are used to treat spaces between teeth and teeth that are chipped, stained or poorly shaped.
– Braces may be needed if teeth are crooked, crowded or do not meet properly – and not just for kids

Even small changes can have a big impact on your smile and so make a huge difference to how you look and how you feel about yourself.

If you’d like an even better smile, your dentist will be able to give you information about the options available.

While our teeth are normally very strong, they can crack for a number of reasons.

Reasons could include tooth decay, trauma/injury, grinding of the teeth or a stress fracture.

Sometimes, our jaw may be stronger than our teeth and the teeth can fracture when we bite heavily on food.

We can protect our teeth in some circumstances – for example it may be advisable to wear a mouthguard during sports.

Taking proper care of the teeth and regular visits to the dentist will help keep your teeth in good shape.

If a tooth cracks, it may become painful if the nerve is exposed and the area can become tender.

If this happens, rinse your mouth with warm water to clean the area and apply a cold compress to reduce swelling. Then call your dentist immediately.

Treatment will depend on where the tooth has fractured, how close it is to the nerve and the overall condition of the tooth.

A cracked tooth may be repaired with silver alloy, gold, porcelain or plastic. Or it may require a crown or overlay or bonding, which applies porcelain or enamel to the fractured tooth.

If you contact your dentist quickly, they will be able to take the most approriate action to preserve the tooth as much as possible.

When you visit a modern dental surgery, its hard to imagine the challenges of dental treatment without all the latest technology.

Yet specialists have been taking care of peoples teeth for thousands of years.

Here are some of the key developments over the last 300 years.

1723: French surgeon Pierre Fauchard – credited as being the father of modern dentistry – publishes the first book to describe a comprehensive system for the practice of dentistry.

1760: John Baker, the earliest medically-trained dentist to practice in America, immigrates from England and sets up practice.

1790: John Greenwood adapts his mothers foot treadle spinning wheel to rotate a drill.

1790: Josiah Flagg, a prominent American dentist, constructs the first chair made specifically for dental patients.

1832: James Snell invents the first reclining dental chair.

1841: Alabama enacts the first dental practice act, regulating dentistry in the United States.

1844: Horace Wells, a Connecticut dentist, discovers that nitrous oxide can be used as an anesthesia and successfully uses it to conduct several extractions in his private practice.

1880s: The collapsible metal tube revolutionizes toothpaste manufacturing and marketing.

1890: Willoughby Miller notes the microbial basis of dental decay in a book which started a world-wide movement to promote regular toothbrushing and flossing.

1896: New Orleans dentist C. Edmond Kells takes the first dental x-ray of a living person in the U.S.

1938: The nylon toothbrush, the first made with synthetic bristles, appears on the market.

1945: The water fluoridation era begins when the cities of Newburgh, New York, and Grand Rapids, Michigan, add sodium fluoride to their public water systems.

1950s: The first fluoride toothpastes are marketed.

1960: The first commercial electric toothbrush, developed in Switzerland after World War II, is introduced in the United States. A cordless, rechargeable model follows in 1961.

Your saliva plays an important role in your oral health and reduced saliva flow can lead to health problems.

Reduced saliva flow can lead to a dry mouth and this is a common problem among older adults.

It can be caused by various medical disorders and is often a side effect of medications such as antihistamines, decongestants, pain killers and diuretics.

Dry mouth can be associated with various problems such as a constant sore throat, burning sensation, problems speaking, difficulty swallowing, hoarseness or dry nasal passages.

Drying irritates the soft tissues in the mouth, which can make them inflamed and more susceptible to infection. Without the cleansing effects of saliva, tooth decay and other oral health problems become more common.

So, if dry mouth is not treated, it can damage your teeth.

Without adequate saliva to lubricate your mouth, wash away food, and neutralize the acids produced by plaque, extensive decay can occur.

Your dentist can recommend various methods to restore moisture. Sugar-free candy or gum stimulates saliva flow, and moisture can be replaced by using artificial saliva and oral rinses.

If you have any kind of swelling in your gum, it almost certainly indicates a serious infection that should be treated urgently.

Dental abscesses result from a bacterial infection in the teeth or gums.

For example, it may come from an untreated cavity. Cavities result when some of the bacteria in our mouths mix with sugars and starches in our diet to produce acid.

This acid attacks the hard enamel coating of our teeth and, as the cavity gets deeper, it eventually infects the nerve and blood supply of the tooth.

In some cases, a dental abscess is caused by an infection of the gum. Bone loss from gum disease can create a pocket between the tooth, gum and bone.

When bacteria and other debris get into this pocket, an abscess can form.

The treatment for an abscess depends on how severe the infection is.

If the abscess has been caused by decay, root canal treatment may be needed or the tooth may even have to be removed.

If the abscess has been caused by the gum, the gum will need deep cleaning or surgical treatment. Again the tooth may need to be removed.

Sometimes, a small incision may be made into the gum to drain the abscess. If this happens, antibiotics and pain medication may be used to relieve discomfort.

If you wait until the gum is severely swollen before seeking treatment, the situation can become very serious.

The abscess at this stage can prevent you breathing properly and can be life-threatenting.

So if you have any signs of swelling in your gum, contact your dentist immediately.

Choosing the right dentist for your needs is an important part of giving yourself the best oral health possible.

Sometimes you may find that things are not working out for the best and it’s important to take steps to resolve any problems rather than just put off your dental care.

First, talk to your dentist about any concerns. They will probably be able to accomodate your needs if you tell them what you are looking for.

In some situations, you may feel that you want to look around at alternative options – maybe there are other dentists who meet your needs better, taking into account factors such as location, office hours, fees and emergency arrangements.

If you are comparing fees, ask for estimates on full-mouth x-rays and a preventive dental visit that includes an oral exam and tooth cleaning.

If you have any doubts about treatment your dentist has recommended, it may be a good idea to set your mind at rest by getting a second opinion from another dentist.

However, even in the best dentist-patient relationship, problems can sometimes occur. If your dentist is not able to resolve your concerns, you can contact your state or local dental association.

They have established systems of peer review that provide an impartial and easy way to resolving misunderstandings regarding the appropriateness or quality of care.

If you are not completely staisfied with the dental treatment you are getting, it’s important ot take steps to put it right – whether you sort it out with your own dentist or find another one.