If you engage in frequent air travel, you have probably experienced pain in your ears and sinuses related to pressure changes. The pain is caused by “barotraumas” (from baro meaning pressure — also the root of the word “barometer” — and trauma meaning injury) and is also called a “squeeze.” Divers also sometimes experience this discomfort or pain.

The cause of barotraumas is air pressure (or water pressure, in the case of divers) on the outside of your body that is not equal to the pressure inside your body. Normally when pressure outside your body changes, your organs such as your blood, bones, and muscles transmit the changes equally from outside to inside. Some structures in your body, such as your middle ear spaces and your sinus cavities (spaces in the facial bones of the skull), don't transmit the pressure as well because they are filled with air and have rigid walls. The maxillary (upper jaw) sinuses are pyramid-shaped spaces in the bone located below your eyes, on either side of your nose.

You have probably tried to stop such pain in your ears by yawning, chewing, or moving your jaw back and forth. These maneuvers, called “clearing,” allow air to move from the back of your throat into your ear canals so that the pressure can equalize. Similarly, your sinuses have small openings near their lower borders, so that you can clear pressure changes within them. If you have a head cold or flu and the membranes lining your sinuses are swollen and inflamed, they may close off the openings and make it difficult to clear these spaces. This can sometimes lead to intense pain.

Because the lower walls of these sinuses are adjacent to your upper back teeth, these teeth share the same nerves as the maxillary sinuses. This sharing sometimes causes pain felt in your back teeth to be perceived as pain in the sinuses, or vice versa. Pain felt a distance from its actual stimulus because of shared nerves is called “referred pain.”

Be sure to make an appointment with us if you experience pain in any of your teeth. Any defect in a filling or tooth can allow air to enter the tooth. It could be referred pain from your sinuses, or the result of pressure changes on trapped air within a filling or a tooth. Such pain, called barodontalgia (from baro meaning pressure, don't meaning tooth, and algia meaning pain) is an early sign of injury in a tooth.

Contact us today to schedule an appointment to discuss your questions about tooth and sinus pain. You can also learn more by reading the Dear Doctor magazine article “Pressure Changes Can Cause Tooth & Sinus Pain.”

Periodontal (gum) diseases are sometimes called “silent” because those who have them may not experience painful symptoms. But certain signs point to the existence of these common diseases. If you are experiencing any of the symptoms below, it is time to visit our office so these problems can be treated before they lead to serious infection and loss of teeth.

Gums that bleed during the brushing of teeth. Some people think that gums bleed from brushing too hard. In fact, healthy gum tissues will not bleed with normal brushing. The usual cause of bleeding gums is an accumulation of dental plaque in the areas where your teeth meet your gums. Plaque is a film of bacteria, called a biofilm, which accumulates on your teeth. If you are not brushing and flossing effectively, plaque irritates your gum tissues and causes an inflammation and swelling called gingivitis. This causes your gums to bleed easily on contact with a toothbrush or floss.

Gum tissues that appear red and swollen. If plaque is allowed to accumulate for 24 hours or more, the inflammation in your gum tissues becomes chronic. The continuous presence of bacteria makes it impossible for your body's natural defenses to fight the infection. Chronic inflammation leads to a breakdown of the normal attachment between the teeth and the gums, causing the formation of “pockets.” Inside these pockets the infection continues to attack the tissues that support your teeth. Eventually this can lead to a breakdown of the bone that surrounds your teeth.

Bad breath. Bad breath is another sign of accumulated plaque. The bacteria in plaque may emit gases that have an unpleasant odor.

Gums that are sensitive to hot or cold. Chronic inflammation can also cause the gums to recede, exposing the roots of the teeth in which nerves may be close to the surface, leading to sensitivity to heat and cold.

Teeth that are getting loose, or a painful area in the gums. If you experience these symptoms, the infection has progressed a long way from the “silent” stage. It is time to seek immediate professional help.

If you answered “yes” to any of the above questions, a professional dental examination is in order. With daily removal of plaque by effective brushing and flossing, along with frequent professional cleanings to remove any plaque that you were unable to catch, you will go a long way to preventing periodontal disease. Also, be aware that smoking tends to mask the effects of gum disease. Generally, if you smoke your gums will not bleed when brushing or flossing, nor will they show signs of swelling.

Contact us today to schedule an appointment to discuss your questions about gum disease. You can also learn more by reading the Dear Doctor magazine articles “Bleeding Gums” and “Warning Signs of Periodontal (Gum) Disease.”

Tongue and lip piercing is a growing popular trend for some young people and adults; however, did you know that they could wreak havoc on oral health? In fact, some people soon discover that before they can even enjoy their new piercing they are faced with issues ranging from bleeding and infection to nerve damage. Tongues and lips are highly vascular — that means they have lots of blood vessels that can bleed easily and are not always easy to stop once they start bleeding. Many tongue and lip bolts can initiate problems such as tooth sensitivity, gum disease and recession, chipped teeth and more. In addition, not all tattoo parlors and tattooists are properly licensed to do piercings. Therefore, sterile techniques are not always guaranteed if they do not come under the scrutiny government agencies. Unfortunately, these potential concerns are rarely discussed prior to receiving a piercing.

So what can be done if you already have a tongue or lip piercing?

If you already have piercings, it is critical that they are closely monitored by your health professionals to make sure they are not doing damage. It is also important that you have routine dental exams to ensure that you do not have any silent problems causing issues that you haven't noticed. However, your best option is to consider removing these oral piercings. The good news is that most often the hole in your tongue or lip may heal itself; otherwise, a minor corrective surgery may be required.

A note of warning: Before you contemplate a piercing, get as much information as you can about them and the person who will do them. This includes asking about their risks, benefits and better alternatives. And then think twice to make sure they will not become permanent and negative reminders of temporary emotions!

Did you know that Americans spend nearly 3 billion dollars each year on fresh breath remedies including gum, mints and mouthrinses to address their fears of halitosis (bad breath)? This simple fact clearly reveals that Americans are obsessed with having pleasant breath. Some other interesting statistics on this subject include:

• 60% of women and 50% of men say they use breath freshening products like candy, chewing gum and sprays
• 50% of middle-aged and older adults have bad breath
• 25% of the population has chronic bad breath
• 20 to 25% of adults have bad breath due to their smoking habits

However, the best way to determine what is causing your bad breath is to have a thorough dental exam followed by a professional cleaning. The first important step of this process begins when we obtain a thorough medical history. This includes asking you questions so that we can:

• Identify your chief complaint and whether or not your bad breath is noticed by others or just a concern you have
• Learn about your medical history as well as what medications (prescription and over-the-counter), supplements, and vitamins you are currently taking
• Learn about your dietary history to see if pungent foods such as garlic and onions are foods you often eat that are contributing to the problem
• Conduct a psychosocial assessment to learn if you suffer from depression, anxiety, sleep or work problems
• Identify personal habits such as smoking cigarettes, cigars or a pipe that contribute to your bad breath

To learn more about the causes and treatments for halitosis, read the Dear Doctor article, “Bad Breath — More Than Just Embarrassing.” Or you can contact us today to schedule a consultation for an examination, cleaning and treatment plan.

Dental caries (tooth decay) is similar to the pesky bumblebee that invades your lovely summer barbecue. You can find temporary solace from this intruder by eliminating that very first bee that you see, but if you are situated in an area that is close to the bee's nest, it won't be long before the next bee buzzes along. This is similar to tooth decay. Having one cavity-laden tooth drilled and filled is really just a temporary fix. The underlying conditions that led to tooth decay in the first place need to be addressed in order for your risk of future infection to decrease.

Researcher Dr. John Featherstone created the concept of the Caries Balance in 2002, in which he explained that tooth decay and overall dental health are dependent upon a proper balance of disease-causing and health-promoting factors. Discovering what the fundamental problem really is (and getting as far away from that hornet's nest as possible) can help both determine and curb your risk for future tooth decay.

Here's the issue in a nutshell: Susceptible teeth, in the presence of acid producing bacteria when fed by sugar from your diet, basically, will create all the conditions necessary to cause tooth decay.

To determine your risk for tooth decay, see how many times you answer “Yes” to the following questions:

1. Do you brush your teeth twice a day to reduce bacterial plaque sticking to the teeth?
2. Do you use fluoride toothpaste to strengthen the teeth against acid attack?
3. Do you use a fluoride mouthrinse?
4. Do you floss daily?

Every affirmative answer decreases your risk of getting cavities, but even doing all of this may not be enough!

Now, how many times can you answer “Yes” to these questions?:

1. Do you smoke? Smoking causes mouth dryness, and creates a host of other health problems.
2. Do you snack frequently between meals? One sugary snack and your mouth is acidic for the next hour. One snack per hour and your mouth is acidic all day.
3. Do you frequently have acid reflux or heartburn? Reflux creates extreme acidity in the mouth and directly erodes tooth enamel.
4. Do you drink soda, sports drinks, or acidic beverages frequently? These beverages are very acidic.
5. Is your mouth frequently dry? Do you take any medications that cause mouth dryness? Saliva is nature's own defense against acidity and helps neutralize acid in the mouth.
6. Have you had frequent cavities in the past and/or have you had any crowns or fillings in the past three months? The best indicator of future disease is past disease!

Every affirmative answer increases your risk of getting cavities!

Now that you are a little more knowledgeable about your personal risk for tooth decay, make an appointment with us to discuss the preventative measures that can give you some control over the future condition of your teeth. Ignoring the risks and then ending up with a mouth full of rotting teeth when you knew better could really sting a little!

To learn even more about the delicate balance between the disease causing and protective factors related to tooth decay, read the Dear Doctor magazine article “Tooth Decay: How To Assess Your Risk.”