My Blog

By Paul D. Nifong, Jr, DDS, PA
April 30, 2019
Category: Oral Health
Tags: toothache  
YourToothacheMightnotbeCausedbyaTooth

A toothache means a tooth has a problem, right? Most of the time, yes: the pain comes from a decayed or fractured tooth, or possibly a gum infection causing tooth sensitivity.

Sometimes, though, the pain doesn't originate with your teeth and gums. They're fine and healthy—it's something outside of your tooth causing the pain. We call this referred pain—one part of your body is sending or referring pain to another part, in this instance around your mouth.

There are various conditions that can create referred pain in the mouth, and various ways to treat them. That's why you should first find out the cause, which will indicate what treatment course to take.

Here are a few common non-dental causes for tooth pain.

Trigeminal Neuralgia. The trigeminal nerves situated on either side of the face have three large branches that extend throughout the face; the branch to the jaw allows you to feel sensation as you chew. When one of the nerve branches becomes inflamed, usually from a blood vessel or muscle spasm pressing on it, it can refer the pain to the jaw and seem like a toothache.

Temporomandibular Joint Disorder (TMD). These two joints that connect the lower jaw to the skull can sometimes become dysfunctional for a variety of reasons. This can set up a cycle of spasms and pain that can radiate throughout the jaw and its associated muscles. The pain can mimic a toothache, when it actually originates in the jaw joints.

Teeth Grinding. This is an unconscious habit, often occurring at night, in which people clench or grind their teeth together. Although quite common in children who tend to grow out of it, teeth grinding can continue into adulthood. The abnormally high biting forces from this habit can cause chipped, broken or loosened teeth. But it can also cause jaw pain, headaches and tenderness in the mouth that might feel like a toothache.

These and other conditions unrelated to dental disease can seem like a tooth problem, when they're actually something else. By understanding exactly why you're feeling pain, we can then focus on the true problem to bring relief to your life.

If you would like more information on oral pain issues, please contact us or schedule an appointment for a consultation.

By Paul D. Nifong, Jr, DDS, PA
April 20, 2019
Category: Oral Health
PopStarDemiLovatoPopsOutJayGlazersTooth

Singer and actor Demi Lovato has a new claim to fame: formidable martial artist. When she is not in the recording studio, on stage or in front of the camera, Lovato can often be found keeping in shape at Jay Glazer's Hollywood (California) gym. Glazer, who is best known as a sports journalist, also runs conditioning programs for professional athletes and celebrities based on mixed martial arts. On March 6, Glazer got more than he bargained for when 5'3" Lovato stepped into the ring and knocked out his front tooth.

Glazer reportedly used super glue to put his tooth back together. Not a good idea! While it may not be convenient to drop everything and get to the dental office, it takes an expert to safely treat a damaged tooth. If you glue a broken tooth, you risk having to undergo major work to correct your temporary fix—it's no easy task to "unglue" a tooth, and the chemicals in the glue may damage living tooth tissue as well as the surrounding gum and bone.

Would you know what to do in a dental emergency? Here are some guidelines:

  • If you chip a tooth, save the missing piece if possible. We may be able to reattach it.
  • If your tooth is cracked, rinse your mouth with warm water, but don't wiggle the tooth around or bite down on it. If it's bleeding, hold clean gauze to the area and call our office.
  • If your tooth is knocked loose or is pushed deeper into the socket, don't force the tooth back into position on your own. Immediate attention is very important.
  • If your tooth is knocked out, there's a chance it can be reattached. Pick up the tooth while being careful not to touch the root. Then rinse it off and have either someone place into its socket, or place it against the inside of your cheek or in a glass of milk. Please call the office immediately or go to a hospital.

What's the best thing to do in an emergency? Call us right away, and DON'T super glue your tooth! You can prevent worse problems by letting a professional handle any dental issues.¬†And if you've been living with a chipped, broken or missing tooth, call us to schedule an appointment for a consultation—there are several perfectly safe ways to restore your smile. Meanwhile, if you practice martial arts to keep in shape, think twice before getting into the ring with Demi Lovato!

To learn more, read the Dear Doctor articles “Trauma & Nerve Damage to Teeth” and “Saving New Permanent Teeth After Injury.”

By Paul D. Nifong, Jr, DDS, PA
April 10, 2019
Category: Oral Health
Tags: oral hygiene  
HeresHowtoCarefor3CommonDentalRestorations

Today's dental restorations are truly amazing. Not only are they life-like and functional, they can endure for many years a hostile environment of bacteria, acid and heavy biting forces.

Even so, you'll still need to take care of your restorations to help them last. Here's how to extend the life of 3 common forms of dental work.

Fillings. We use fillings, both metal amalgam and tooth-colored materials, to repair holes or cavities in teeth caused by tooth decay. Although strong, dental fillings can break if you subject them to abnormally high biting force (like chewing ice). There's also a chance that if a slight separation occurs between the filling and tooth, bacteria can take up residence and reignite the decay process. To prevent this, practice a daily regimen of oral hygiene to clean away bacterial plaque—and reduce sugar in your diet, a prime food source for bacteria.

Veneers. Usually made of thin porcelain, veneers are bonded to the front of teeth to mask chips, stains, gaps or other blemishes. But although they're strong, veneers aren't immune to damage. Habits like biting nails, the aforementioned ice chewing or unconsciously grinding your teeth could cause a chipped veneer. And if periodontal (gum) disease causes your gums to recede, the exposed part of the tooth may look noticeably darker than the veneer. To protect your veneers and their appearance, avoid habits like ice chewing, and seek treatment for teeth grinding and dental disease.

Bridgework. Bridges are used to replace one or more missing teeth. Traditional bridges use the natural teeth on either side of the gap to support the bridge; for a single missing tooth, implants are a preferable option because they don't require permanently altering the neighboring teeth to support it. With either option, though, you should brush and floss around the restoration to reduce the risk of dental disease. Infections like gum disease or tooth decay could eventually weaken the bridge's supporting teeth or gum disease can damage an implant's gum and bone support.

With any dental restoration, be sure to practice daily oral hygiene, eat a nutritious, low-sugar diet, and see your dentist regularly for cleanings and checkups. Taking care of your dental work will help it take care of you for a long time to come.

If you would like more information on maintaining your dental restorations, please contact us or schedule an appointment for a consultation.

By Paul D. Nifong, Jr, DDS, PA
March 31, 2019
Category: Oral Health
Tags: tooth decay  
PreventingDentalDiseaseStartswithAssessingYourUniqueRisk

Over the last century dentistry has acquired the knowledge, techniques and treatments to prevent or minimize tooth decay. With this enhanced knowledge we’ve amassed a wealth of data about what increases dental disease development and what prevents it.

This has produced a balanced approach to identifying and treating disease-causing factors and incorporating factors that inhibit tooth decay. Known as Caries Management By Risk Assessment (CAMBRA), this approach first identifies each patient’s individual set of risk factors for dental disease and then develops a customized prevention and treatment plan to minimize their risk.

Rather than simply reacting to occurrences of tooth decay — “drill and fill” — CAMBRA anticipates and targets your susceptibility to decay. The primary factors can be represented by the acronym BAD: Bad bacteria, particular strains that produce acid, which at high levels erode enamel and expose the teeth to infection; Absence of saliva, or “dry mouth,” an insufficient flow of saliva that can’t effectively neutralize acid and restore mineral content to enamel; and Dietary habits too heavy in sugar or acid, which can result in bacterial growth and enamel erosion.

With an accurate picture of your particular risk level we can then apply countering factors from the other side of the balance — those that protect teeth from decay. In this case, we use the acronym SAFE: stimulating Saliva flow when needed or applying Sealants on chewing surfaces most susceptible to decay; Antimicrobials that reduce unhealthy bacteria levels and give healthy bacteria an opportunity to thrive; incorporating Fluoride, a chemical known to strengthen enamel, through hygiene products or direct application to the teeth; and an Effective diet, low in sugar and acid and high in fresh fruits, vegetables and whole grains.

There are a number of preventive and treatment measures that fall into each of the four preventive factors. Using the CAMBRA approach we can develop a treatment and prevention plan that incorporates measures that uniquely fit your dental health situation. With such a plan we can greatly reduce your risk of disease development and impact and better ensure a long and healthy life for your teeth and gums.

If you would like more information on managing dental disease prevention, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “Tooth Decay: How to Assess Your Risk.”

By Paul D. Nifong, Jr, DDS, PA
March 21, 2019
Category: Dental Procedures
Tags: laser dentistry  
TheLaserRevolutionisChangingtheDentalHealthcare

Lasers have transformed our everyday lives, especially in healthcare. These intense beams of light of a single wavelength have revolutionized all manner of diagnostics and treatments, from general surgery to cosmetic therapy.

Dentistry has also been influenced by the laser revolution. Here are just a few of the areas where they’re growing in use and popularity.

Early disease detection. Laser instruments can take advantage of “fluorescence,” the tendency of bacteria to “glow” when exposed to certain wavelengths of light. This is proving more effective in detecting early tooth decay in pits and fissures (very tiny areas in a tooth’s biting surface) than traditional needle-like probing instruments called dental explorers. Newer lasers can now detect the same fluorescent qualities in soft tissues, which may reduce the detection time for oral cancer and make the difference between life and death.

Dental caries treatment. Lasers have become an alternative to the dental drill in treating teeth with dental caries (decay). Although with larger cavities lasers are somewhat slower than the conventional drill, they truly shine when it comes to early enamel caries and small cavities because they can be quite precise in the amount of tooth structure they remove. This feature allows them to be less invasive than a dental drill.

Periodontal treatment. Periodontal (gum) disease is an infection caused mainly by bacterial plaque and calculus (hardened plaque deposits) that have adhered to tooth surfaces. Lasers are emerging as an alternative to conventional periodontal (gum) surgery to treat voids or spaces below the gum line called periodontal pockets that have formed because of gum tissue detachment as supporting bone is lost. With their ability to target and destroy infected tissue without damaging nearby healthy tissue, lasers can achieve similar outcomes as traditional techniques but with less tissue damage and discomfort to patients afterward.

Research and development into laser technology continues to perfect these and other applications that promise to make dental procedures less invasive and more comfortable for patients.

If you would like more information on the use of lasers in dentistry, please contact us or schedule an appointment for a consultation.





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