When Teeth Hurt from Seasonal Allergies

When is your child’s toothache not really a toothache? When the pain results from a seasonal allergy. In the spring and fall, natural allergens such as flower and tree pollens and molds can seriously affect some children (and adults, too). Other allergens that can spark similar reactions year-round include dust mites and animal dander.

Once an allergic child inhales allergens from the air, the child’s body senses that these substances are foreign and “need” to be eliminated. So the body produces a response—but that response is imperfect. It includes the production—and often overproduction—of thick mucus.

If there is more mucus than necessary and it can’t be easily discharged, it pools in head cavities called sinuses. These spaces are normally filled only with air, but they become receptacles for mucus when it’s produced. The pressure from the overabundant mucus can lead to a sinus headache.

What does this have to do with the teeth? The maxillary sinuses are located just above the roots of the back top teeth (premolars and molars). When these sinuses are swollen and overflowing, they exert pressure on the roots, causing pain that feels exactly as a toothache would feel if there were something wrong with a tooth. Symptoms include oversensitivity to cold, throbbing and pain when biting down or if the tooth is tapped from the outside.

However, no dental problem actually exists. Adults have a difficult time telling the difference between a sinus-induced problem and a true tooth issue; it’s even more difficult for a child.

So, if your child complains of a toothache but is also susceptible to seasonal allergies, try to address the allergic symptoms first and see if the tooth pain lessens. In consultation with your pediatrician, you may want to try an antihistamine, decongestant and/or nasal spray.

In some cases, the toothache may be gone faster than that new box of tissues.

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First Aid for Your Child’s Tooth Injury

Nearly half of all children suffer a tooth injury during childhood, most often from falls, traffic accidents, fighting and sports. Taking immediate action can help lead to a better outcome after treatment. Be prepared to tell us how and when the injury occurred. After we examine your child, we may recommend imaging, if necessary, to determine the extent of the injury and develop a treatment plan. 

Treatment varies depending on whether the injury involves a primary tooth or a permanent tooth. Loose or dislocated permanent teeth are always emergency situations. Here are some of the most common childhood tooth injuries and their treatments:

  • Dislocated or loose primary tooth: The goal of treatment for this common injury is to prevent future damage to the permanent teeth. A loose baby tooth left in place sometimes heals without treatment. If it is very loose, your dentist may remove the tooth to prevent it from falling out and becoming a choking hazard. If knocked out completely, the tooth should not be replaced into the gum. This could cause damage to the underlying permanent tooth.
  • Broken primary tooth: A dentist should examine the child as soon as possible to see if there is damage to the tooth’s nerves or blood vessels. Treatment may include smoothing the rough edges of the tooth, repairing it with resin material, leaving it in place or removing it.
  • Dislocated permanent tooth: Try to replace the dislocated tooth in its socket within 15 minutes of the injury, then call the dentist. If you are unable to replace it, place the tooth in cold milk and get to the dentist right away. The tooth usually survives if stored in milk and replaced within one hour. Teeth stored dry and reimplanted after one hour rarely survive.
  • Loose permanent tooth: Prompt dental treatment usually returns the tooth to its correct position. Sometimes, the dentist may use stitches or splints to hold the tooth in place until it heals.
  • Broken permanent tooth: These can usually be repaired successfully, especially if treated within two days of the injury. Tooth fragments can sometimes be reattached and should be stored in tap water until you get to the dentist. If the fragments cannot be found or reattached, the dentist may repair the tooth with a resin material. 

Depending on the injury, your child’s dentist may prescribe pain medication or antibiotics. Eating a diet of soft foods and maintaining good oral hygiene with twice daily brushing and regular flossing assists in recovery. With your immediate first aid and prompt professional care, most childhood tooth injuries heal successfully and rarely lead to complications.

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Extreme Mouth Makeover: Express Route to a Beautiful Smile

Are you and your teen happy with his or her smile? One of the wonderful things about the teenage years is the ability to finally do something about the dental issues that have always bothered you and your teen.

Crooked or missing teeth, gummy smiles or discolored teeth can now be fixed permanently in ways that were not appropriate when your child was younger. If your teen has several problems that need correcting, you might want to consider a smile makeover—a full overhaul that corrects cosmetic dental concerns in a comprehensive way.

Instead of tackling one issue at a time (whitening teeth now at one dental office, seeing someone else in a year about a missing tooth), smile makeovers approach the mouth in a holistic way, looking at the big picture. Smile makeovers can fix alignment and spacing, discoloration, chipped or missing teeth, and even alter the smile line.

We assess the entire mouth and determine what procedures your teen needs. These procedures may include veneers, implants, whitening or composite bonding. You’ll see a more consistent, natural result with this approach because we consider everything—your child’s tooth coloring, the shape of the teeth and gum line, and overall cosmetic goals—rather than treating each issue separately. Costs can be more easily contained this way, and because procedures can be performed simultaneously, time spent in the dentist’s chair can be minimized.

The teen years are a great time to embark on a smile-improving journey, and a smile makeover is a fabulous way to achieve the results you and your teen desire. Talk to us about options for your particular situation.

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When Children Grind Their Teeth

Bruxism is the formal name for teeth-grinding, which occurs when a person moves the jaw while holding his or her teeth together. It often occurs during sleep, and younger people are more susceptible to it than older ones. Up to 30% of children grind their teeth; most outgrow it. (Some professionals also include jaw-clenching in the definition of bruxism.) If you’ve never heard a child grind his or her teeth before, you may be surprised how much harsh noise can come out of that little mouth.

If your child grinds his or her teeth while awake, behavior modification often works to break the habit. We can work with you to support behavior modification techniques or suggest other professionals who can help.

A child who grinds his or her teeth while asleep requires different treatment altogether. Behavior modification won’t work because the child is fully unconscious while grinding. In this case, a specially fitted mouthguard or splint is most often the treatment of choice. While it can require a short period of adjustment, the child certainly benefits in the long run.

If your child is probably going to outgrow bruxism, why treat it at all? In the short term, it can cause headaches, fatigue, overdeveloped jaw muscles, even jaw dysfunction. In the long term—especially because even if bruxism stops on its own, it can go on for years—your child’s teeth may be permanently worn down and hypersensitive from the act of grinding. That’s an outcome you certainly want to avoid.

Even if you are not aware of your child’s bruxism, most dentists will be able to tell if your child suffers from it by the symptoms, such as morning jaw pain combined with a flattening of the teeth. If there is any doubt, a sleep study can be performed to check, but this isn’t usually necessary.

On the other hand, sometimes problems other than bruxism occur during your child’s sleep—interrupted breathing (apnea), for instance, that could cause excessive daytime sleepiness. In such a case, you and your child’s physician should discuss consulting a sleep specialist.

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Wisdom Teeth: The Basics

Wisdom teeth are the third and final set of molars that most people get in their late teens or early 20s. These teeth can be a valuable asset to the mouth when healthy and properly aligned, but more often they are misaligned and require removal.

Misalignment can take many forms: Wisdom teeth may position themselves horizontally, be angled toward or away from the second molars, or be angled inward or outward. Poor alignment of wisdom teeth can crowd or damage adjacent teeth, the jawbone or nerves.

Wisdom teeth also can be impacted—enclosed within the soft tissue and/or the jawbone, or fail to fully partially break through the gum. Partial eruption of a wisdom tooth creates an opening for bacteria to enter around the tooth and cause an infection, which can result in pain, swelling, jaw stiffness and general illness. Such teeth are also more prone to tooth decay and gum disease because their hard-to-reach location and awkward positioning makes brushing and flossing difficult.

Sometimes, your child’s wisdom teeth should be extracted even before problems develop. This is done to avoid a more painful or more complicated extraction that might have to be performed a few years later. Removal is easier in younger people because their wisdom teeth roots are not yet fully developed and the bone is less dense.

Ask us about the positioning of your child’s wisdom teeth. We may take x-rays periodically to evaluate the presence and alignment of the wisdom teeth. If we detect possible problems, we may recommend that your child visit an oral surgeon for further evaluation.

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TMJ Disorder: Time for Dental Help?

Tummy aches and scraped knees: Parents learn to manage those early in the game. But when your child grows into adolescence and develops something more unusual, like jaw pain, it can be harder to know when a visit to a health professional—in this case your dentist—is warranted.

The two temporomandibular joints, or TMJs, connect the lower jaw to the skull. Mild TMJ discomfort—moderate pain, tightness, soreness—isn’t rare, especially in girls. It’s often brought on by stress that can cause or exacerbate jaw-clenching or teeth-grinding, which, in turn, causes TMJ discomfort. Over the course of several days as the stress lessens or your child becomes more aware of her actions and tries to stop the pain-causing behavior, TMJ discomfort usually disappears on its own. You can promote healing by having your teen apply heat or cold to the jaw, providing over-the-counter pain relievers, and encouraging him or her to avoid hard-to-chew foods for a while.

However, if these home remedies don’t work and the pain lasts for two weeks or more, then a visit to your dentist is probably in order. If the movements associated with chewing, smiling or even talking have become challenging; if headaches, dizziness, or ringing in the ears is involved; or if the jaw feels like it “locks up” when either opened or closed, professional attention is certainly warranted.

Your dentist may diagnose stress-related jaw actions (especially during sleep) as contributing to TMJ pain; if so, your dentist may fit your teen with a custom-made splint or biteplate to wear while asleep. Sometimes a TMJ disorder might lead to malocclusion (a misaligned bite) that may require orthodontic treatment. If the TMJ problem occurs in conjunction with pain in other joints, arthritis must be considered as a possible cause.

Surgery is rarely necessary. Most TMJ disorders are treatable with simple remedies—but your teen needs to take seriously any corrective measures so his or her TMJ disorder doesn’t become markedly worse.

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