Emergency visit?

At our office, coming in for an emergency visit on a Sunday doesn’t have to be so bad. Dr. Andresen’s granddaughter Eyla raids the toybox and plays some tunes after hours to make you feel better.

My gums have always bled when I brush. Couldn’t that be normal for me?

Any bleeding from your gums is a sign of infection.  Maybe you’ve had some gum infection from the time you were younger, and has been present for so long, it seems normal.  The easiest comparison would be for your scalp to bleed when you brushed your hair.  We all know that’s not normal, but your gums are a form of skin just as is your scalp.

The good news is that gum infection is often easy enough to fix, and we can show you how to get back to normal, healthy gums with various cleaning techniques you can do at home.  Even if you have been a regular dental flosser, you may still have gum disease.  Flossing doesn’t guarantee healthy gums, so there are other effective ways to prevent disease, or cure the infection that may be present.

We assess the health of your gums and suggest the most efficacious way for you to have healthy gums.  Some gum infections have been present so long that serious damage may have occurred, including bone loss around the roots.  Bleeding gums can eventually lead to tooth loss, so early diagnosis is critical to its prevention.  Gum infection, as indicated by bleeding gums, is implicated in cardiovascular conditions, diabetes, and  various other medical conditions,  Again, we will inform you of your state of dental health, and if wanting, will show the way to good dental health.

My front teeth are getting rough. What should I do?

I’m assuming you’re talking about the biting edge of your teeth, so this answer applies to that condition.  Roughness is often the result of rubbing your upper and lower teeth together, often done while you sleep.  Roughness is usually the first sign of a grinding condition, and precedes actual change in shape of your tooth.  You may know someone that has very short teeth. That is usually the result of years of grinding, and was at some point early in their years manifested with the initial roughness you question.

Some restorative procedures may be necessary early in the condition, but usually, we recommend a guard you wear at night to prevent the wearing away of enamel caused by the rubbing together of your teeth.  Again, a diagnosis of the cause is necessary before jumping to conclusions, so if you have such a concern, let’s take a look.

The hygienist recommended x-rays for my teenager, but I’m reluctant to allow that. Can’t you see cavities visually?

We understand the concern, but digital x-rays are ultra low dose images, and allow us to see developing cavities long before they are visible to one’s eye alone.

Once you become aware of a cavity, either through a hole appearing in a tooth, or sensitivity, it may be more difficult to treat, so digital xrays allow more conservative treatment, often avoiding a root canal or crown or similar additional expense.  We take the minimum images consistent with sound diagnosis, and don’t take them at every visit.  Patients who have demonstrated excellent oral hygiene and no cavities over a period of some years may have x-rays taken only once every 5 years or more.  We don’t have a one size fits all approach to x-rays, but rather, determine a proper interval for each patient.

My teeth have been very sensitive lately. Does that mean I have a cavity?

Not necessarily.  There are many causes of tooth sensitivity, including decay, but the most common forms of sensitivity usually don’t require more than simple measures you can do at home.  It’s wise to have it checked by us to ensure there are no serious concerns, such as decay or a tooth with a crack.  Decay that is causing sensitivity is usually serious enough to require, at a minimum, a restoration of some sort, often a crown.  A cracked tooth is usually sensitive to biting pressure as well as temperature, usually cold.  It requires a crown to fix, and in some cases, a root canal filling.

Other causes can be some tartar control toothpastes, or tooth whitening agents.  But the most common cause of sensitivity is acid exposure on the teeth.  Acid is the most common flavoring ingredient in soft drinks, candy, cough drops, sport drinks,  and an amazing array of dietary products.  Read labels, and look for acids of any name, such as citric acid, phosphoric acid, maleic acid, etc.  One of the most common conditions we have been seeing recently are teenagers with tooth sensitivity accompanied by enamel erosion on the chewing surface of molars, making divot-like holes on the cusp tips of the molars, and associated with a history of eating sour candies.  Gummy bears, Sour Patches, Jolly Ranchers, etc can all cause tooth sensitivity, but, worse, can eat away the enamel of your teeth.

Another common cause of acid-caused sensitivity is a difficult-to-diagnose exposure to stomach acid.  Many people aren’t aware of a gastric reflux condition until confirmed by a physician, but stomach acid is strongly acidic, and can cause very painfully sensitive teeth, often on one side only, usually the side they sleep on.  That allows acid to pool around those teeth at that side, exposing them to high concentration of hydrochloric acid.  The good news about acid-caused sensitivity is that it can improve dramatically when the offending acid is removed (eliminate soft drinks, etc).