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Maybe it will go away…

These are, without a doubt, the most dangerous words in the English language. Don’t wait to see if it will go away. Contact us as soon as possible. If you have immediate dental concerns, we would like to help. We will try to work you into our schedule as quickly as possible during our regular office hours.

When something isn’t right, there is an awareness of a dental problem. The best plan is to get it checked out as soon as possible. These seemingly “little” problems can escalate rapidly into intensely painful problems that can progress to situations that can be difficult to get under control.

When can a dental problem be life-threatening? If you have an infection around a tooth or gum, especially in the lower jaw, the infection can spread downward into your neck and can cause enough swelling to cut off your airway. Don’t wait for that to happen!

If you feel that there is a possibility of swelling down into your neck, do yourself a favor. Go immediately to your nearest hospital emergency department, where you can be helped. Regular dental care will certainly minimize the chances you’ll have a dental emergency, but problems do happen even with the best care.

The inside of the mouth is a hostile environment. A lifetime of chewing food, presence of sugar, clenching, grinding, stomach acid reflux, medicines that dry up saliva production, mouth breathing, combined with sometimes less than adequate home care, give you a hostile environment for teeth. I hope you “get” the emphasis on sugar. It is “poison” for teeth!

It is not out of the realm of possibility that a tooth will break. If a tooth breaks, it will likely be sensitive, but sometimes it is not. If it is not sensitive, it might be okay, right? Wrong, a fractured tooth is a problem. It cannot grow back or repair itself.

A fractured tooth is now open for attack by all the bacteria in the mouth. Eventually, the fractured tooth can decay. This can lead to infection, gum disease, pain, abscess, tooth loss, difficulty chewing, tooth migration, a gap in your smile, and unwillingness to smile because of embarrassment.

We want to have a chance to repair that broken tooth as soon as possible. It is our goal to get you in for an evaluation and treatment as quickly as possible. We can often get you the same day that you have a problem to assess the nature of the problem, begin treatment to ease your pain, reduce symptoms, and start repairing the problem.

Symptoms Not to Ignore

Cold Sensitivity

Teeth are supposed to be able to feel cold. It is not an emergency if you are outside in Maine on a cold day, and your teeth are sensitive to the sub-zero air. However, if one tooth is more sensitive to cold than others, it often means that something is causing the pulp or nerve center of the tooth to be inflamed.

Inflammation causes swelling. Inside the confines of the place where your tooth pulp lives, there is no room for swelling! Add to this, if you place a cold on the tooth (maybe ice cream or a cold drink), it will make the tooth shrink microscopically, putting painful pressure on the inflamed nerve.

What to do? Several things can cause a tooth to be inflamed, including recent dental work, clenching, grinding teeth, gum recession, exposure of the root surface, a cavity, a failing filling or crown, biting on something hard, cracking, or a fracture in the tooth. These are some of the many possibilities for reasons for a cold or temperature-sensitive tooth.

Sometimes it is not easy for the dentist to find the direct cause of dental concerns, but it is crucial to have the dentist check out the situation, especially if it has lingered for more than two weeks. Many temporary inflamed pulps will resolve within a couple of weeks. If it lasts longer or becomes more sensitive, come and see us!

Heat Sensitivity

As with cold sensitivity (see cold sensitivity above), a tooth is supposed to feel the heat. There may be heat and cold sensitivity in pulp with inflammatory changes in the tooth’s pulp. There may be a difference, though, that may be significant in the instance of heat sensitivity.

If the pain is immediate and prolonged, it may mean that the tissue in the tooth’s pulp has advanced to such a state that the pulp tissue is dying. This is a situation where you do not want to wait. Make an appointment to come in as soon as possible to have the tooth evaluated!

Sweet Sensitivity

Although the network of nerve tissues throughout the interior of a tooth is vast, it is very well contained and protected as long as there is no break in the tooth’s surface. Sweet sensitivity is a pain response to the presence of sugar. It represents an exposure of the network of nerve endings to that sugar stimulus.

Sweet sensitivity is often found where there is a cavity in a tooth or a leak or gap around a filling or crown. As tooth structure breaks down from bacterial and acid invasion, these nerve endings become exposed. Certain chemicals can become a painful stimulus or “sweet sensitivity.”

Also, if the gum tissue has receded, exposing large areas of the teeth’ root surfaces, these areas can become sweet sensitive. Most of the time, this exposure occurs over time. These micropores in the tooth surface become plugged with debris, so the nerve endings are not exposed.

But, tooth grinding, abrasion, acidic food, or drinks can open these pores allowing the tooth to become sensitive to many things, including sweet. No matter what, sweet sensitivity is not a typical symptom and should be investigated as soon as possible. Sweet Sensitivity? Contact us for an appointment!

Pressure Sensitivity

During normal chewing, forces on teeth can be in the range of 20 – 80 psi. This is a considerable amount of force that is generated by our muscles. We are generally not even aware of the force unless there is a problem.

Forces that are placed on our teeth at other times. Say, for instance, while clenching our teeth. Pressure from grinding (bruxing) during sleep can be far greater, in the range of 300 – 3,000 psi.

The extreme forces that occur on teeth during sleep are the forces that contribute to wearing down and crack formation in teeth. The wear and tear of sleep bruxism can lead to a lot of damage. It can ultimately be a source of pressure sensitivity.

Teeth that cavities and subsequently fillings have weakened do not withstand those extreme forces well. They can become cracked and, therefore, sensitive. If gum disease is present and there has been considerable bone loss around the roots of teeth, this can also contribute to pressure sensitivity.

There is yet another situation that may sometimes be a factor in pressure sensitivity. Suppose a person applies heavy muscular pressure to the muscles used for chewing over long periods of time, as is when a person habitually clenches their teeth while sleeping. Small “trigger points” can develop in muscles that, when stimulated, can refer pain to certain teeth.

Tooth sensitivity to pressure is not a normal symptom. It should be investigated as soon as possible to find out the cause. Contact us for an appointment!

Pain While Chewing

As is the case with pressure sensitivity, teeth should not hurt when chewing normal foods. Teeth are designed to withstand tremendous pressures. Unless there is something wrong, they should not hurt.

Cracks can occur in teeth. Then when pressed on, they can cause pain and other dental concerns. This happens along the crack as the pieces move against one another. Sometimes the first symptom is when you bite on something hard or something you don’t expect, like a bone fragment or raspberry seed.

Old silver fillings are not “bonded” to the tooth. When they were put into the tooth, the dentist would place small indents or undercuts in the tooth’s wall to hold the silver in. Over time, these undercuts can allow weakening of the tooth leading to cracks.

The bigger the filling, the more possibility of cracks occurring. It’s time to have it checked at the first sign of chewing pressure sensitivity on one of these teeth with old silver fillings. Contact us for an appointment.

Muscles fatigued from heavy clenching all night can be sore when it comes to time use them to chew with. Clenching at night is often related to obstructive sleep apnea or other breathing problems while asleep. Tightening the “clenching” muscles also tightens the pharyngeal muscles used in maintaining an open airway.

If you are having this kind of problem, you must seek care. As dentists, we cannot diagnose sleep apnea, a potentially severe health problem, but we work together with physicians to treat these disorders. We are happy to point you in the right direction to diagnose and treat sleep-disordered breathing problems.

Bleeding Gums

Pink toothbrush bristles are not normal. Bleeding gums are not normal. The most likely cause of bleeding gums when brushing or flossing is gum disease.

The CDC acknowledges that probably more than half of all American adults have some form of gum disease. Gum disease can be seen as a mild case of “gingivitis” (inflamed gums) to the extreme of severe periodontitis (severe gum disease with bone loss and tooth loss). Quite often, there may be absolutely no pain involved in any of the spectrum of this disease.

It is difficult to understand how a disease process comes with little or no pain. It is only through the vigilant pursuit of reducing gum disease that we will overcome the bleeding. The physical sign that possibly differentiates gum disease’s bleeding gum disease from other possible health problems is that the bleeding occurs when brushing or flossing. In other words, it’s in the physical activity of scrubbing the teeth that we see the bleeding occur.

It is important to note that bleeding in the mouth that occurs spontaneously, without the activity of cleaning teeth or eating, may have serious health consequences. Spontaneous bleeding may be due to the presence of oral cancer, blood clotting disorders, or even leukemia. No matter what the cause of bleeding gums, it is vitally important to have it evaluated!

Swelling

Swelling is a sign of infection. There are no dental concerns where swelling is not a significant problem. All swelling must be taken seriously without delay. Significant swelling that affects the lower jaw or the neck can be life-threatening.

The accumulation of pus in the spaces around the neck can restrict breathing and cause suffocation. For obvious reasons, if swelling should ever encroach on the airway, the local emergency department must be consulted immediately! Any swelling must be diagnosed as soon as possible so that proper treatment can be begun to avert possible grave consequences.

Spontaneous Pain

If one has risked taking the chance that “maybe it will go away,” the result may be that minor dental concerns will become major dental concerns. Spontaneous pain, pain that comes with no provocation, is usually a sign that one has waited too long and that a serious tooth infection is at hand. Wait no longer! Contact us for an evaluation appointment as soon as possible!

Fractured Teeth

When a piece of the tooth comes off, it is cause for immediate distress. No one expects this to happen. There may be immediate pain, or oddly, there may be no pain.

Regardless, a fractured tooth needs to be evaluated as soon as possible. Fractured teeth are dental concerns. They cannot grow back or repair themselves.

A fractured tooth is now open for attack by all the bacteria in the mouth. Eventually, the fractured tooth can decay. This can lead to infection, gum disease, pain, abscess, tooth loss, difficulty chewing, tooth migration, a gap in your smile, and unwillingness to smile because of embarrassment.

What will become of a fractured tooth? First, it depends on the severity of the fracture or crack. Where is the defect? Is it above the gum line or below? Is the pulp exposed? Is there bleeding?

Is the root fractured or cracked? Is there a fractured piece still attached to the gum tissue? All these questions need to be answered as soon as possible. Contact our office to schedule an appointment!

Tooth Knocked Out

Various dental concerns can ultimately result in a permanent tooth being knocked out or dislodged from its normal position. If the lost tooth is a deciduous or “baby” tooth, it is rarely necessary to replace it. If the permanent tooth is dislodged but not knocked out completely, it may be possible to push it back into place gently. You may be able to bite the tooth back into place, but it is essential to see the dentist as soon as possible to have it assessed and treated.

If an adult tooth is knocked completely out, it is important to see a dentist as soon as possible, preferably within 30 minutes. Handle the tooth only by the crown. If dirty, rinse it gently with water. Do not scrub the tooth, dry it, or place it in a cloth or tissue.

If possible, gently place the tooth back in its socket as soon as possible. This will give the tooth the best chance to survive. If this is not possible, keep the tooth moist by placing it in a “Save a Tooth” kit or milk. It can also be kept moist by placing it back in the mouth next to the cheek until the dentist can treat it. In any case, it is essential to see a dentist, preferably within 30 minutes.

Fractured Jaw

It goes without saying that a broken jaw needs immediate attention, preferably in a local hospital’s emergency department. However, we have seen one situation in which the patient’s jaw had been broken. They had no other dental concerns other than the fact that their teeth no longer fit together.

If you are aware that teeth are suddenly not fitting together properly, it is a good reason to be evaluated as soon as possible. It isn’t likely that the jaw is broken without some evidence of trauma, but muscle spasms or temporomandibular joint problems can also affect how teeth fit together. Regardless, it is essential to contact us for an evaluation appointment!

Bad Breath / Bad Taste

Halitosis, or bad breath, is not something that would normally be construed as an emergency. However, awareness of a bad breath or bad taste problem may be evidence of something awry in the mouth. Several medical problems like diabetes can cause bad odors. A bad taste may be associated with an infected tooth or drainage from a gum disease abscess. Come in to get it checked out!

Dry Mouth

Dry mouth is becoming more prevalent these days. Many prescription drugs contribute to decreasing the volume of saliva production. Although this may not be considered an emergency, it may lead to much more severe dental problems.

A dry mouth can generally lead to more inflammatory gum problems. It can promote cavity formation, as there is significant neutralization of acidity in the mouth by the more basic saliva. It is important to approach dry mouth effects with an effective strategy to prevent the problems.

Lumps and Bumps

We arduously look for abnormalities when we do periodic examinations (check-ups). It is normal for soft tissue, cheek or tongue, to raise a welt if you accidentally bite it. Without other similar reasons, lumps and bumps inside the mouth are abnormal. Generally, anything that persists longer than two weeks without returning to normal should be considered abnormal and should be evaluated.

As part of every check-up examination, we do a thorough intraoral cancer-screening exam. This involves visually examining all the accessible tissues inside the mouth, the tongue, the lips, and areas around the mouth. We also check for swellings, lumps, discolorations, and changes in lymph nodes. Any positive findings are referred for further diagnosis and treatment.

It cannot be overstressed the importance of having any persistent abnormality evaluated as soon as possible. Oral cancers are comparatively rare. However, they can be deadly. “Maybe, it will go away” is a dangerous strategy to take with dental concerns.

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John T. Hauge, DMD, has been a practicing dentist for nearly 41 years, is a graduate of the University of Pennsylvania School of Dental Medicine and has been practicing in Maine for the last 17 years. Although he has ample experience in all areas of dentistry, Dr. Hauge has special interest and extra experience in treating patients with obstructive sleep apnea and TMJ pain problems.