Dental Emergencies

This time of year gets very busy for everyone.
Some people are trying to maximize there dental benefits and squeeze in treatment before the year ends and that keeps us busy in the office, although there are a some appointment slots left between Christmas and New Years.  However, it is the holidays that keep most of us really busy.  Whether its trying to get ready to head out of town to see family, prepare the house for family that is coming to visit or just trying to get all that last minute shopping and decorating done, the countdown to the end of the year begins well before the countdown to see the ball drop in Times Square.
We all know of Murphy's Law as well.  If something can go wrong, it will go wrong.  The dental extension of this is that it will go wrong at the worst time possible.  You may be out of town, it may be the weekend we aren't open here at the office, or you may be just too busy to get in.
Here is a quick rundown of some of the emergencies that we see year round and with increased frequency this time of year.
Lost Caps or Crowns:  All those holiday caramels that your Great Aunt dropped by can definitely pull off crowns.  The great hope is that the top part of the tooth did not come with it.  If the tooth hasn't had root canal treatment it is probably sensitive as well.  Try and get in ASAP to get it re-cemented as teeth can shift and break.  Do you best to be prepared to not swallow it as well.  It happens more than you think.
Broken or Lost fillings:  The same candies that pull off crowns can break off fillings.  Again, teeth under fillings are almost always sensitive, get in and have a new one placed.
Cracked teeth:  Biting into those hard nuts and candies can break more than fillings, it can break the tooth.  Teeth that are cracked are typically very painful on release of pressure.  Cracked teeth can be tricky.  If they crack in the best way possible, we may be able to smooth it out or put a small filling in.  Most teeth that have cracks due need a full coverage crown at the very least.  Depending on the path of the crack, it may break the wrong way and need a root canal, if it breaks REALLY the wrong way, it may need to come out.  Some cracks are readily visible and some don't show up on xrays.  Avoiding eating on the tooth is usually key to preventing pain.
Swelling:  If you are starting to experience swelling it is usually due to a gum infection or a tooth that needs a root canal getting out of hand.  Many times you've know about it and have been putting it off.  Call us immediately.  If we can't be reached, urgent care or the emergency room should be your next call.  You need treatment immediately.
Sometimes, things are easy to treat at home.  Some cold sensitivity on breathing the freezing cold can send a sharp pain to the tooth.  Trying a sensitivity toothpaste is usually a great way to take care of it.  If the tooth has any lingering sensitivity that seems to hang on or cause spontaneous pain, again get in and see us.
There are many other types of emergencies, most are an obvious sign to get in, others are much more silent.  Frequently, by the time something hurts, bigger treatment is necessary.
Do your best to avoid things you know aren't good for you, but if something happens we can be reached at (925) 634-1230 or visit http://www.freitasdentistry.com to check out our FAQs.  After hours emergencies call (925) 240-3308 to reach us quickly.

Sensitive Teeth

One of the complaints we hear the most is about sensitive teeth.  There are lots of reasons that sensitivity can occur and treatment can be as little as a change in toothpaste.

The most common sensitivity we see is due to a receding gumline.  Much like we see with a receding hairline, there isn't a completely predicable way get your gums back to there ideal place.  Recession can be cause by a many different things.  Sometimes we have thin gum tissue after teeth have been moved outward with orthodontics, sometimes it's due to gum disease (gingivitis and periodontitis), but most frequently it is due to brushing too hard with too stiff bristles and too much toothpaste.

While an aggressive routine is great at removing plaque, it can cause physical trauma to the the gums that over time will leave the root of the tooth exposed.  The root of the tooth is not covered by enamel and made up of dentin.  Dentin is naturally the bulk of the tooth.  The crown of the tooth is also made mainly of dentin, but is covered by enamel which is much stronger.

When brushing, you want to make sure you are using as gentle a touch as possible.  It doesn't take a lot of force to disrupt the plaque buildup on your teeth.  Also, it is important to use the softest bristles possible.  Why do firm bristles exist if they aren't good for your teeth?  They are great for cleaning the grout around your toilet and that's about it.  Make sure you know which brush is for which spot!  Also, many toothpastes are very abrasive, especially those that are "Whitening" or "Tartar Control."  We recommend using a regular toothpaste or a sensitivity toothpaste that contains fluoride and use only enough for flavor.  The big strip of toothpaste in the commercials is only great at using up more toothpaste so you have to buy more.

Trauma from brushing isn't the only way to get exposed dentin though, and exposed dentin isn't the only cause of sensitivity.  Other causes include recently placed tooth colored fillings, cavities near the gumline, having your teeth whitened (especially the in office Zoom type of whitening sessions, but that's for another blog), acid erosion (soda habit, acid reflux, or more sinister drug habits) and grinding of the teeth.

Don't hesitate to bring up any sensitivity issues you have and we will work with you to make sure to help limit the sensitivity.  Having sensitivity is relatively common and it doesn't mean you can't enjoy a glass of ice water, or whiten your teeth, or for some, even take a breath on a cold day, it just means that a few extra precautions need to be taken.

Welcome to the first post of the Freitas Family Dentistry Dental Blog.  My goals for this blog are to posts thoughts I have on different topics, especially those topics that are brought up by patients.  I always want people to feel free to post questions they have regarding their oral health and I'll do my best to get helpful answers to you.
Feel free to post questions on our Facebook page at https://www.facebook.com/RobertJFreitasIIDDSFamilyDentistry?ref=hl or by emailing us a drfreitas@freitasdentistry.com.  You can always bring it up at any appointment as well.
We hope people will find this blog helpful we will try and post something around once a week.