We've all heard the expression when we've had a close call. "I made it by the skin of my teeth". Did you know that there really is such a thing? The skin of our teeth is called a pellicle (pell/uh/kul). It is a thin film of proteins and sugars that is formed from our saliva that seals microscopic defects in the enamel of our teeth. This is an important function.
Proper diagnosis of oral pain is a skill that all dentist take very seri¬ously. Referred pain is an interesting phenomenon that can make accurate diagnosis very challenging. Because of the way that nerves are arranged in the head and neck, and the way our brains interpret the signals sent along these nerves, the place that we fell pain may not be where the pain is really coming from.
There are several common examples of referred pain involving the teeth and jaws. It is not usual for a diseased lower molar tooth to cause pain that feels exactly like an ear-ache. It is very common for these patients to go to their medical doctor only to find out that the ear is fine. Doctors will send their patients to their dentist and it is usually discovered that a bad lower tooth was the cause of pain referred to the ear. At this time of year, many people are having sinus problems. Si¬nusitis often causes referred pain to the upper teeth. This pain feels exactly like a toothache even though the teeth are prefectly healthy.
Children and adults that are wearing braces still need to see their family dentist regularly. During orthodontic treatment, regular brushing and flossing is more difficult because of brackets, bands and wires. Bacterial plaque easily accumulates around the braces and it can be a real challenge to remove it. If the plaque remains on the teeth, we usually see a severe inflammation of the gum tissue called gingivitis. In addition, the tooth structure around the braces is very susceptible to decay. It is very disappointing when a patient has their braces removed only to reveal several cavities.
A new device has recently become available for home oral hygiene. "Spin brushes" are inexpensive, battery operated toothbrushes. I checked at a local supermarket and the prices ranged from six to twelve dollars. Many of the spin brushes were designed for children and they seemed very appealing. One designed by Colgate was based on a Lego toy. I saw a Crest spin brush that looked like a cell phone. There were others based on popular cartoon characters. Most of the brushes are powered by AA batteries and had brush heads that could be replaced when they wear out.
Every dentist I've ever met would like his patient's fillings to last forever. However, while a good many restorations do sustain for the life of the tooth, no filling ever becomes an organic, integral part of it. Thus none CAN be guaranteed to last indefinitely.
Even a filling placed with the best intentions and preparation can fail for a variety of reasons. If there is not enough of an undercut in the remaining tooth structure, the filling can fall out. Occasionally a part of the tooth around the filling will break, loosening the lock, and the filling will fall out. If decay somehow recurs, the filling may become surrounded by decay, loosen and fall out. It should also be noted that, the larger the filling, the greater risk of fracture from chewing forces.
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