Having a Toothache That's Not a Toothache?

Having a Toothache That's Not a Toothache?

By Mina Levi, DDS, 08/07/2014

At the dental office of Dentist San Francisco Mina Levi, DDS in the heart of Union Square, we see a number of interesting and educational dental cases. These cases can serve as learning models in order for patients to become educated about some of the symptoms they may be having, how to treat these symptoms, or what to do to prevent certain situations from occurring. In this article, we discuss a case of a toothache that a patient had that ended up not being caused by a tooth at all.

 

A 49 year old female A.M. saw Dentist Mina Levi DDS in San Francisco as an emergency due to severe pain. It extended to the ear and even radiated to her neck. She was certain that the back most tooth, her second molar, was the culprit.

Dr. Mina Levi examined the tooth. It had a large filling, but there was no evidence of decay or a fracture. The Dentist San Francisco examined all the other teeth on the right side of both jaws. They responded normally to temperature and percussion tests (where Dr. Mina Levi will tap each tooth to determine if the surrounding ligament and bone are inflamed). X-rays of the teeth revealed no evidence of decay or infection.

Dr. Mina Levi then palpated (using her finger to exert mild pressure) around the tooth, and there was no pain. Palpating the muscles of the right Temporomandibular Joint ("T.M.J.) caused SEVERE pain. The dentist asked the patient if she was aware of clenching or grinding her teeth. She said that she was aware that she clenched her teeth, and that she hasn't worn her night guard lately. She also mentioned that she was very anxious lately.

The patient was reassured that she did not need endodontic ("root canal") therapy. Her pain was due to muscle spasms of her T.M.J. and she was referred out to a specialist who  prescribed muscle relaxants and anti-inflammatory medications. She received also a Botox treatment for her muscle pain. Dr. Mina Levi made a night guard for the patient and advised her to start wearing it every night.

The T.M.J. muscles are just in front of, below and above the ear. So, it's easy to understand how the pain radiated to her ear. But, how, you may wonder, did they cause neck pain?

 

Think of a fine Swiss watch. Each part is carefully calibrated to work in harmony with every other part. If just one part malfunctions (or is slightly "off,") the balance and harmony of the entire system is disrupted. So it is with the muscles of the head and neck. Grinding and clenching of the teeth irritates the T.M.J. muscles. This can cause slight changes in the person's posture. These postural changes, however slight, cause straining of the neck muscles and results in pain. So, you see, proper dental diagnosis requires understanding not just of the teeth, but of the fine-tuned, complex relationship of the oral cavity to the rest of the body.

If you are experiencing neck or jaw pain, or have toothache-like symptoms and would like to discuss TMJ and treatment options, visit Dentist San Francisco Mina Levi, DDS on the web at www.minalevidds.com or give us a call at (415) 513-5066.

Topics: Dentist San Francisco, TMJ, TMJ San Francisco, toothache, toothache pain, tooth pain, jaw pain, neck pain, neck pain San Francisco, jaw issues, clenching at night, grinding at night, clenching and grinding the teeth, night guard, night guards San Francisco, grinding teeth, mouth guards, mouth guards for grinding, TMJ dentist San Francisco, clicking jaw, popping jaw

 

Understanding TMD and What to do about it

Understanding TMD and What to do about it

By Mina Levi, DDS, 04/03/2014

About five to twelve percent of the world population suffers from temporomandibular joint dysfunction or temporomandibular disorder (TMD). This describes a variety of conditions affecting the joints, muscles, and nerves in the jaw. In this article, we discuss what TMD is, what causes it and what to do about it if you have it.

What are the temporomandibular joints?

The temporomandibular joints are located on either side of your face right in front of your ears, and connect your lower jaw to your skull. These joints and their accompanying muscles allow you to open and close your mouth, as well as allow you to move your lower jaw from side to side. These joints are easily felt by placing your hands in front of your ears and opening and closing your mouth.

What is TMD?

TMD occurs when the temporomandibular joints are damaged in some way, or when the muscles accompanying the joint are not working properly, which causes an imbalance in jaw movement. Painful chronic muscle pain and spasms are associated with this disorder.

What causes TMD?

A lot of the time, the cause underlying TMD is unclear. TMD may be caused by trauma like an injury or dislocation, or an improper bite, which affects the chewing muscles. Stress behaviors like clenching and grinding teeth may make the condition worse. TMD appears to be more common in women than men.

Signs and Symptoms of TMD

Those who suffer from TMD may experience the following symptoms:

·         Jaw pain/soreness that is more prevalent in the morning or in the evening

·         Jaw pain that is aggravated by chewing, biting or yawning

·         Clicking noises when opening and/or closing the mouth

·         Difficulty opening and closing the mouth

·         Locking or stiff jaw

·         Tooth sensitivity not associated with other dental problems such as decay or restorative work

·         Headaches or neck pain

·         Earaches

The dentist can perform an examination of the joints and muscles of your jaw if you feel that you may be suffering from any of these symptoms or think that you may have TMD.

How is TMD treated?

Some TMD cases can be handled with these lifestyle modifications:

·         Avoiding chewing gum and biting of the nails

·         Eating softer foods

·         Stress relief techniques

·         Taking non-aspirin pain relievers to manage pain

In more severe TMD cases, the dentist will most likely recommend physical therapy, appliance therapy, or medication.

Is TMD permanent?

TMD is a cyclical condition that can recur during times of stress. If you have this disorder, make sure to see the San Francisco dentist for regular checkups so that your symptoms can be monitored and your special care can be managed. For more information about TMD or the signs and symptoms of TMD, visit Dr. Mina Levi DDS on the web at www.minalevidds.com or give us a call at (415) 513-5066.

Topics: TMD, TMJ, TMD disorder, clenching and grinding, night guards, appliance therapy, physical therapy, dental restorations, tooth sensitivity, headaches,earaches, jaw pain, San Francisco dentist, dental problems, dental decay, dental cavities, temporomandibular joints, mandibular joints, jaw problems, jaw clicking, jaw popping

What You Need to Know About Wisdom Teeth

What You Need to Know About Wisdom Teeth

By Mina Levi, DDS 03/20/2014

When your wisdom teeth grow in properly, they are just like all of your other teeth and help in the act of chewing. However, most of the time they become impacted or erupt at a strange angle in the mouth, which can cause pain and discomfort. In this article, we discuss wisdom teeth and the necessity of their removal.

What are wisdom teeth?

Wisdom teeth are another name for the third molars, or the third of the larger teeth that are in the very back of the mouth where you chew most of your food. Most people have three (including the wisdom teeth) permanent molars in each quadrant of the mouth, twelve all together. The first molars usually erupt around age six or so, while second molars erupt around the age of twelve. Third molars, or the wisdom teeth, are the last to erupt if they erupt at all. They are called wisdom teeth because they tend to develop later in life, between the ages of seventeen and twenty-one.

Why do wisdom teeth sometimes need to be removed?

Some wisdom teeth may become impacted or prevented from erupting properly, mainly due to the lack of space in the mouth to fit them. Dr. Mina Levi normally recommends extracting impacted wisdom teeth because they can cause many problems, such as infection, decay of neighbor teeth, gum disease, and tumors. Wisdom teeth that do successfully erupt are often times very difficult to reach and keep clean and may become badly decayed and need to be removed. Other times that erupted wisdom teeth need to be removed include when they are nonfunctional, interfering with your bite, involved with or at risk of gum disease, or causing problems with neighbor teeth or dental restorations. Sometimes wisdom teeth areextracted in order to prevent these things from happening.

How do I know if I need my wisdom teeth removed?

Individuals whose wisdom teeth need to be removed may experience a variety of symptoms, such as pain, infection, and swelling of the face or gums. Dr. Mina Levi will determine whether you need your wisdom teeth removed by taking X-rays and examining your mouth. Wisdom teeth that are not removed will be monitored, as they can cause problems later in life. Extraction is usually an outpatient procedure and can be performed either by a dentist like Dr. Mina Levi or an oral surgeon using local sedation or a general anesthetic.

Are there any complications associated with wisdom tooth extractions?

The most common complication associated with wisdom tooth extractions is called a “dry socket”, a painful condition that occurs when the blood clot at the extraction site does not develop properly or is lost prematurely. This blood clot serves as the foundation for new tissue and bone to develop around the extraction site, so dry socket delays the healing process. To prevent dry socket from occurring, do not smoke, consume carbonated beverages, or drink through a straw after a wisdom tooth extraction. Rinsing with salt water can help keep the area clean after an extraction, but excessive spitting or rinsing can be harmful in the healing process. Normally, using a syringe to rinse the area is sufficient. Before your tooth extraction, make sure to tell Dr. Mina Leviand her dental team about any medications you are taking, as they could interfere with the healing process. To avoid complications, follow Dr. Levi’sinstructions regarding eating and drinking, pain management, and keeping the extraction site clean.

Everyone’s mouth and teeth are different, and only a dental professional can determine whether or not your wisdom teeth need to be removed. If you have concerns regarding your wisdom teeth or would like some more information, give Dr. Mina Levi a call at (415) 513-5066 or visit us on the web to schedule an appointment.

Topics: wisdom teeth, wisdom teeth extractions, wisdom teeth eruption, tooth extraction, impacted wisdom teeth, tooth extraction complications, dry socket, jaw pain, tooth pain, gum disease, dental decay, dental restorations, San Francisco dentist, tooth removal