Dental Problems

Abscessed Tooth

An abscessed tooth is caused by an infection. Bacteria from this infection typically travels down the pulp (the tooth’s softcore) then spreads from the root of the tooth, through the bone, to the tissue surrounding the tooth and presents as a pimple of pus.

An abscessed tooth can be extremely painful. In some cases, antibiotics are administered in an attempt to kill and infection. Treatments involve a nerve treatment to removed the infected pulp or an extraction with a space maintainer.

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Bad Breath (Halitosis)

Bad breath is caused by a variety of factors. In most cases, it is caused by food remaining in the mouth - on the teeth, tongue, gums, and other structures, collecting bacteria. Dead and dying bacterial cells release a sulfur compound that gives your breath an unpleasant odor. Certain foods such as garlic and onions, contribute to bad breath odor. Once food is absorbed into the bloodstream, it is transferred to the lungs, where it is exhaled. Brushing, flossing and mouthwash only mask the odor. Dieters sometimes develop unpleasant breath from fasting.

Gum disease is caused by plaque - the sticky, of the colorless, film of bacteria that constantly forms on teeth. Dry mouth or xerostomia may also cause bad breath due to the decreased salivary flow. Saliva cleans your mouth and removes particles that may cause odor. Bad breath may also be a sign that you have a serious health problem such as a respiratory tract infection, chronic sinusitis, postnasal drip, chronic bronchitis, diabetes, gastrointestinal disturbance, liver or kidney ailment.

Bad breath may also be caused by medications you are taking.

Daily brushing and flossing of the teeth and brushing of the tongue will normally take care of unpleasant breath. If your dentist determines that your mouth is healthy and that the odor is not oral in nature, you may be referred to your family physician or to a specialist to determine the cause of the odor and possible treatment.

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Bulimia Nervosa

Fourteen out of 100,000 people suffer from bulimia nervosa, which primarily affects adolescent and young adult females. It is an eating and psychiatric compulsive disorder that can lead to serious problems with your child's teeth if left untreated. One-third of those who suffer from bulimia nervosa have a history of anorexia nervosa, and one-third of those who suffer from bulimia nervosa have a history of obesity.

Bulimia nervosa is characterized by periods of normal eating followed by dieting or severe restrictions of food intake, often ending in binge-eating. Binge-eating episodes must occur at least twice a week for three months to be diagnosed as bulimia nervosa. Weight gain is controlled by self-induced vomiting, strict fasting, vigorous exercise, and abuse of laxatives or diuretics.

Repeated episodes of induced vomiting can lead to enamel erosion of all teeth due to the chronic exposure to acid in vomit. Bulimia nervosa, and its accompanying dry mouth from decreased salivary flow and parotid gland dysfunction, also can lead to a dramatic increase in cavities because of excessive carbohydrate intake during binge-eating.

Typically, patients who suffer from bulimia nervosa have small, purplish-red lesions on their palate due to contact with objects used to induce vomiting. Silver fillings often become raised due to erosion of the teeth, and braces and temporary restorations may not stay on the teeth because the acid will dissolve the temporary cement used to keep these materials in place. Teeth may be discolored or look dull from the acid.

Avoid brushing teeth after vomiting, and rinse with water instead. Use a basic rinse, such as baking soda and water; immediately after vomiting to neutralize the acid. Remove plaque by brushing and flossing properly. Chew sugarless gum to increase salivary flow or use artificial saliva. Use fluoride either in toothpastes, rinses or gels to reduce sensitivity of teeth and build resistance to decay from acid.

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Cavities and Tooth Decay

Tooth decay is another name for the disease known as "caries," or cavities. A cavity is the result of your tooth enamel, dentin, or cementum being destroyed over long-term exposure to harmful bacteria.

Many cavities are preventable Tooth decay is promoted by your teeth being frequently exposed to foods rich in carbohydrates (starches and sugars) like soda, candy, ice cream, milk, and cakes. Ironically, even fruits, vegetables, and juices can lead to tooth decay.

When these foods break down in your mouth, they provide food for the bacterial film on your teeth and gums called plaque. The plaque interacts with deposits left on your teeth from sugary and starchy foods to produce acids. These acids break down tooth enamel over time by dissolving, or demineralizing, the mineral structure of your teeth. This leads to tooth decay and weakening the teeth.

Plaque is a film of bacteria that forms on teeth and gums after eating foods that produce acids. These foods may include carbohydrates (starches and sugars), such as candy and cookies, and starchy foods, such as bread, crackers, and cereal.

Tooth decay leads to cavities and occurs when plaque remains on your teeth for an extended period of time, allowing the bacteria to "eat away" at the surfaces of your teeth and gums. Ironically, the areas surrounding restored portions of teeth (where fillings, or amalgams have been placed) are particularly vulnerable to decay and are a breeding ground for bacteria.

In addition to causing cavities, plaque can lead to gum irritation, soreness, and redness. Sometimes, your gums may begin to bleed as a result of plaque accumulation. Long-term, plaque can lead to serious problems. Sometimes, the bacteria can form pockets of disease around tooth structures, eventually destroying the bone beneath the tooth.

In regards to early childhood caries, avoid putting your baby or small child to sleep with a bottle containing anything but water, because juices and milk contain sugars that can be harmful to teeth. When a child sleeps, these liquids "pool" in the mouth and bathe the teeth.

Early childhood caries may occur when sweetened liquids, such as milk, formula, and fruit juice, are given and are left to pool in an infant's mouth for long periods of time. Baby bottle tooth decay can lead to severe cavities in your child's mouth, and destroy the teeth if left untreated.

Avoid allowing your child to fall asleep with a bottle and avoid breast feeding at will after the first baby tooth begins to erupt.

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Gingivitis and Gum Disease

Periodontal disease is a condition in which the structures that support the teeth, including the gums and bone surrounding each tooth, become infected and begin to break down. Periodontal disease (also known as "periodontitis") can be influenced by the body's response to infection caused by the bacteria in plaque. Poor oral hygiene in children could set the stage later on for gum disease - the major cause of tooth loss in adults. It is most often caused by bacteria.

In the early stage of gum disease, called gingivitis, the gums can become red, swollen and easily bleed. At this stage, the disease is still reversible and can usually be eliminated by daily brushing and flossing.

Like some diseases, gum disease isn't painful until it reaches a more critical stage, in which treatment options narrow. If it goes unchecked, inflammation begins to allow surrounding bone to demineralize and dissolve. As the bone dissolves around the teeth in the more advanced stages of gum disease, called periodontitis, the gums and bone that support the teeth can become seriously damaged. The teeth can become loose, fall out, or have to be removed.

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If your child complains of a toothache, rinse his or her mouth with warm water and inspect the teeth to be sure there is nothing caught between them. If pain continues, use a cold compress to ease the pain. Do not apply heat or any kind of aspirin or topical pain reliever directly to the affected area, as this can cause damage to the gums. Children's pain relievers may be taken orally. Schedule an appointment immediately.

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People living with diabetes are vulnerable to a host of systemic problems in their entire body. Unfortunately, the mouth and teeth are not immune from such problems, and many diabetics with oral problems go undiagnosed until conditions become advanced.

Infections and other problems such as receding gums and gum disease, or periodontal disease, are common afflictions among diabetics for many reasons; for instance, diabetics often are plagued by diminished saliva production, which can hamper the proper cleansing of cavity-causing debris and bacteria from the mouth. In addition, blood sugar levels that are out of balance could lead to problems that promote cavities and gum disease.

As with any condition, good oral hygiene, including regular brushing, flossing and rinsing, as well as the proper diabetic diet, will go a long way in preventing needless problems.

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Dry Mouth

Saliva is one of your body's natural defenses against plaque because it acts to rinse your mouth of cavity-causing bacteria and other harmful materials. Dry mouth (also called Xerostomia) is a fairly common condition that is caused by diminished saliva production. People with medical conditions, such as an eating disorder or diabetes, are often plagued by dry mouth. Eating foods such as garlic, tobacco use, and some kinds of medications, can diminish the body's production of saliva, leading to dry mouth. Other causes are related to aging (including rheumatoid arthritis), and compromised immune systems.

Some of the less alarming results of dry mouth include bad breath. But dry mouth can lead to more serious problems, including burning tongue syndrome, a painful condition caused by lack of moisture on the tongue.

If dry mouth isn't readily apparent, you may experience other conditions that dry mouth can cause, including an overly-sensitive tongue, chronic thirst or even difficulty in speaking.

If you don't have a medical condition that causes it, dry mouth can be minimized by sipping water regularly, chewing sugarless gum and avoiding smoking. Of course, there is no substitute for regular checkups and good oral hygiene.

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Enamel Hypoplasia

Enamel hypoplasia refers to the underdevelopment, malformation or weakening of a tooth's enamel or protective outer layer. These areas usually appear as either a dull chalky-white or yellowish-brown appearance and may affect a small spot or majority of the tooth's surface. The fragile areas typically erode over time and can lead to advance dental problems. This condition occurs while the teeth develop in an unborn child. It may be attributed to maternal complication during pregnancy, including illness, poor nutrition, anemia, severe nausea, premature birth, consumption of medications, environmental factors, and exposure to smoke or pollutants. This condition can also occur on permanent teeth. The period begins at birth and extends to around 8 years old. It is attributed to poor nutrition, anemia, prolonged fevers, childhood illnesses, chronic ear infections and use of some medications during the calcification period of the tooth. In the beginning stages a prescription strength fluoride toothpaste or gel can help prevent further enamel destructions. More involved teeth can require a sealant, dental filling material, cementation of a stainless steel crown, or in most severe cases an extraction.

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Enamel Decalcification

This condition occurs when the enamel becomes weakened and the protective layer is destroyed. It appears to be a chalky white appearance and is typically seen along the gum line of the molars and canines. Decalcification forms when plaque remains on a tooth surface for an extended period of time. The bacteria which contains acids and sugars etch away the tooth surface. It goes from a smooth "glass like" appearance to a "chalky", roughened whitish hue. A cavity can be avoided by keeping these areas clean with proper brushing and using a fluoridated or xylitol toothpaste to help remineralize the surface. In more severe cases frequent applications of fluoride varnish may be recommended to help reduce the risks for decay. If a cavity does eventually develop the decay will be removed and a restoration will be placed.

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Fluorosis is characterized by dark brown stains. It does not affect the function of the teeth or weaken them like hypoplasia. Fluorosis often appears on the enamel of the tooth as tiny white streaks or specks. It is so faint that often is unnoticeable. In its most severe form the tooth appearance becomes more discolored by brown markings over time. The enamel may feel rough or pitted and is sometimes hard to clean. Enamel fluorosis occurs only when baby and permanent teeth are developing and prior to eruption of the tooth. Once it is present in the mouth and erupted, it can not longer be affected by this.

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Teeth Grinding (Bruxism)

Teeth grinding (also called bruxism) is often viewed as a harmless, though annoying habit commonly seen in young, developing children.

Though this can cause jaw problems in adults, children don't often present the same symptoms or conditions. It is especially common in preschoolers and children developing their first permanent molars. Tooth grinding can be induced by stress, congestion, development, and also be a subconscious reaction to growth. However, the real cause is still unknown because children who don't present any of the above can still grind their teeth. There is no treatment recommended or required for tooth grinders in the primary dentition. We do continue to monitor the wear on the the enamel surfaces.

If signs of bruxism are noted in the mixed or permanent dentition such as wear of the teeth or popping sounds or pain when you open and close your mouth, therapy is suggested. This usually involves the use of a nightguard worn while sleeping.

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When babies are teething, usually between the ages of four months and 2.5 years, they often have sore and tender gums. The pain usually can be soothed by gently rubbing the baby's gums with a clean finger, a small, cool spoon or a wet gauze. A clean teething ring for the baby to chew on also may be helpful.

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Impacted Teeth/Wisdom Teeth

Our office must examine your child's mouth and X-rays to determine if the teeth are impacted or will not grow in properly. Impacted teeth may cause problems that can lead to infection, adjacent tooth resorption, gum disease, cysts, or tumors.

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Jaw Disorders/TMD

The temporomandibular joint (TMJ) connects the lower jaw, called the mandible, to the temporal bone at the side of the head. Because these joints are flexible, the jaw can move smoothly up and down and side to side, enabling us to talk, chew and yawn. Muscles attached to and surrounding the jaw joint control its position and movement.

When we open our mouths, condyles, or the rounded ends of the lower jaw, glide effortlessly along the joint socket of the temporal bone. A soft disc lies between the condyle and the temporal bone to ensure smooth motion. This disc absorbs shocks to the temporomandibular joint from chewing and other movements.

Temporomandibular (jaw) disorders, also called "TMD" or "TMJ syndrome," are a general class of health problems associated with the jaw. TMD may occur when the jaw twists during opening, closing, or side-motion movements. These movements affect the jaw joint and the muscles that control chewing.

TMD is not just one disorder, but a group of conditions, often painful, that affect the jaw joint (temporomandibular joint, or TMJ) and the muscles that control chewing. Although researchers don't yet know how many people actually have TMD, the disorders appear to affect about twice as many women as men, according to the National Institute of Dental and Craniofacial Research.

Fortunately for most people, jaw joint or jaw muscle pain is usually not a sign of a more serious problem. Pain and discomfort from TMD is temporary and sporadic, and can come in waves or "cycles."

Only a small percentage of people with TMD pain develop significant, long-term symptoms, according to National Institute of Dental and Craniofacial Research.

Temporomandibular disorders fall into three main categories:

  • Myofascial pain, the most common form of TMD, which is discomfort, or pain in the muscles that control jaw function and the neck and shoulder muscles
  • Internal derangement of the joint, dislocated jaw or disc, or injury to the condyle
  • Degenerative joint disease, such as osteoarthritis or rheumatoid arthritis in the jaw joint
  • Severe injury to the jaw or TMJ can cause the problem. Arthritis in the jaw joint may also follow an injury. Orthodontic treatment, such as braces and the use of headgear, has also been blamed for some forms of TMD, but studies now show that this is unlikely, according to National Institute of Dental and Craniofacial Research.

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Pacifier/Thumb/Finger Sucking


The large majority of children suck their thumbs or fingers as infants, and most grow out of it by the age of four, without causing any permanent damage to their teeth. If your child continues sucking after permanent teeth erupt, or if he sucks aggressively, let us know and we can check to see if any problems may arise from the habit.

The large majority of children suck their thumbs or fingers as infants, and most grow out of it by the age of four, without causing any permanent damage to their teeth. If your child continues sucking after the age of 3, or if he sucks aggressively, let us know and we can check to see if any problems may arise from the habit.

Pacifier Use

As newborns get older, sucking serves many purposes. It often makes them feel comforted, secure, and happy. The soothing effect can calm nerves and anxiety especially when separated from a parent and for sleep purposes. Pacifier habits can eventually cause an open bite where the top and bottom front teeth don't come into occlusion. It is an easier habit to break when compared to a thumb or finger habit. We recommend to try and eliminate this habit before the child's 3rd birthday. This will allow the teeth to drift back into their natural position.

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Lacerations and Cuts

Any kind of cut to your face and the delicate soft tissues inside your mouth should be addressed immediately in order to prevent further tissue damage and infection.

If a traumatic injury involves a broken facial bone such as the jaw, nose, chin or cheek, maxillofacial surgery may be required.

With jaw surgery, rubber bands, tiny wires, metal braces, screws or plates are often used to keep a fractured jaw in place following surgery. This allows the bone to heal and stay in proper alignment. Dental splints or dentures may also be required to supplement the healing process following jaw surgery.

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Oral Cancer

Oral cancer is one of the most common cancers today and has one of the lowest survival rates, with thousands of new cases being reported each year. Fewer than half of all people diagnosed with oral cancer are ever cured.

Moreover, people with many forms of cancer can develop complications—some of them chronic and painful—from their cancer treatment. These include dry mouth and overly sensitive teeth, as well as accelerated tooth decay. If oral cancer is not treated in time, it could spread to other facial and neck tissues, leading to disfigurement and pain.

Older adults over the age of 40 (especially men) are most susceptible to developing oral cancer, but people of all ages are at risk. Oral cancer can occur anywhere in the mouth, but the tongue appears to be the most common location. Other oral structures could include the lips, gums and other soft palate tissues in the mouth.

Warning Signs

In general, early signs of oral cancer usually occur in the form of lumps, patchy areas and lesions, or breaks, in the tissues of the mouth. In many cases, these abnormalities are not painful in the early stages, making even self-diagnosis difficult.

Here are some additional warning signs:

  • Hoarseness or difficulty swallowing.
  • Unusual bleeding or persistent sores in the mouth that won't heal.
  • Lumps or growths in other nearby areas, such as the throat or neck.

If a tumor is found, surgery will generally be required to remove it. Some facial disfigurement could also result.


Prevention is the key to staving off oral cancer. One of the biggest culprits is tobacco and alcohol use. Certain kinds of foods and even overexposure to the sun have also been linked to oral cancer. Some experts believe certain oral cancer risk factors are also hereditary.

A diet rich in fruits and vegetables is one of the best defenses against oral cancer. Maintaining good oral hygiene, and regular dental checkups, are highly recommended.

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Plaque is a film of bacteria that forms on your teeth and gums after eating foods that produce acids. These foods may include carbohydrates (starches and sugars), such as candy and cookies, and starchy foods such as bread, crackers, and cereal.

Tooth decay, commonly known as cavities, occurs when plaque remains on your teeth for an extended period of time, allowing the bacteria to ‘eat away’ at the surfaces of your teeth and gums. Ironically, the areas surrounding restored portions of teeth (where fillings, or amalgams have been placed) are particularly vulnerable to decay and are a breeding ground for bacteria.

Plaque can lead to gum irritation, soreness, and redness. Sometimes, your gums may begin to bleed as a result of plaque. This gradual degeneration can often cause gums to pull away from teeth. This condition is called receding gums.

Long-term plaque can lead to serious problems. Sometimes, the bacteria can form pockets of disease around tooth structures, eventually destroying the bone beneath the tooth.

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Sensitive Teeth

Hot and cold temperature changes cause your teeth to expand and contract. Over time, your teeth can develop microscopic cracks that allow these sensations to seep through to the nerves. Exposed areas of the tooth can cause pain and even affect or change your eating, drinking and breathing habits.

Sensitive teeth result when the underlying layer of your teeth (the dentin) becomes exposed. This can happen on the chewing surface of the tooth as well as at the gum line. In some cases, sensitive teeth are the result of gum disease, years of unconsciously clenching or grinding your teeth, or improper or too vigorous brushing (if the bristles of your toothbrush are pointing in multiple directions, you're brushing too hard).

In some cases, desensitizing toothpaste, sealants, desensitizing ionization and filling materials including fluoride, and decreasing the intake of acid-containing foods can alleviate some of the pain associated with sensitive teeth.

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