Dental Problems
Abscessed Tooth
Do I have an abscessed tooth?
A toothache that is severe and continuous and results in gnawing or throbbing pain or sharp or shooting pain are common symptoms of an abscessed tooth. Other symptoms may include:
Pain when chewing
Sensitivity of the teeth too hot or coldBitter taste in the mouth
Foul smell to the breath
Swollen neck glands
General discomfort, uneasiness, or ill feeling
Redness and swelling of the gums
Swollen area of the upper and lower jaw
An open, draining sore on the side of the gum
What is an abscessed tooth?
An abscessed tooth is a painful infection at the root of a tooth or between the gum and a tooth. It’s most commonly caused by severe tooth decay. Other causes of tooth abscess are trauma to the tooth, such as when it is broken or chipped, and gingivitis. These problems can cause openings in the tooth enamel, which allows bacteria to infect the center of the tooth (called the pulp). The infection may also spread from the root of the tooth to the bones supporting the tooth.
How will Dr. Markowitz treat an abscessed tooth?
Strategies to eliminate the infection, preserve the tooth, and prevent complications are Dr. Markowitz’s goals of treatment.
To eliminate infection, the abscess may need to be drained. Achieving the drain can be accomplished by a procedure called a root canal. Root canal may also be recommended to remove any diseased root tissue after the infection has subsided. Then, a crown may be placed over the tooth. The tooth may also be extracted, allowing drainage through the socket. Finally, a third way to drain the abscess would be by incision into the swollen gum tissue. Antibiotics are prescribed to help fight the infection. To relieve the pain and discomfort associated with an abscessed tooth, warm salt-water rinses and over-the-counter pain reducing medications like Advil or Motrin can be used.
Bad Breath (Halitosis)
What causes bad breath?
What you eat affects the air you exhale. Certain foods, such as garlic and onions, contribute to bad breath. Once the food is absorbed into the blood stream, it is transferred to the lungs, where it’s expelled. Brushing, flossing and mouthwash will only mask the odor temporarily. Odors continue until the body eliminates the food.
If you don’t brush and floss daily, particles of food remain in the mouth, collecting bacteria, which can cause bad breath. Food that collects between the teeth, on the tongue and around the gums can rot, leaving an unpleasant odor. Dentures that are not cleaned properly or frequently can also harbor odor-causing bacteria and food particles.
One of the warning signs of periodontal (gum) disease is persistent bad breath or a bad taste in the mouth
Bad breath is also caused by dry mouth, which occurs when the flow of saliva decreases. Saliva is necessary to cleanse the mouth and remove the particles that may cause odor.
Tobacco products cause bad breaths, stain teeth, reduce one’s ability to taste foods and irritate gum tissue.
Bad breath may also be the sign of a medical disorder, such as local infection in the respiratory tract, chronic sinusitis, postnasal drip, chronic bronchitis, diabetes, gastrointestinal disturbance, liver or kidney ailment.
What can I do about my bad breath?
Regular check ups will allow Dr. Markowitz to detect any problems such as gum disease, a dry mouth, or other disorders that may be the cause. Maintaining good oral hygiene, eliminating gum disease and scheduling regular cleaning are essential to reducing bad breath.
Brush twice a day and clean between your teeth daily with floss or interdental cleaners. Brush your tongue, too. If you wear dentures, be sure to remove them at night and clean them thoroughly before replacing them the next morning.
Avities and Tooth Decay
What is tooth decay?
Tooth decay is a destruction of the tooth enamel. It occurs when foods containing carbohydrates (sugars and starches) are frequently left on the teeth. Bacteria that live in the mouth thrive on these foods, producing acids as a result. Over a period of time, these acids destroy tooth enamel, resulting in tooth decay.
What is a cavity?
A cavity is a hole in a tooth that is caused by tooth decay.
How will Dr. Markowitz fix my cavity?
Simple cavities are treated by first removing the decay and cleaning the affected area with a high speed hand piece. The cleaned out cavity will then be filled with either porcelain or composite. By closing off spaces where bacteria can enter, a filling also helps prevent further decay.
Some cavities are too large to be filled. If the damage is very extensive, and too much of the tooth tissue has decayed, Dr. Markowitz may recommend an inlay or crown. If the cavity has been left untreated, and the tooth has become infected it may require a root canal. The sooner you have your tooth examined, the more options Dr. Markowitz will have to preserve your natural tooth.
How can I prevent cavities?
Brush your teeth correctly. In addition, brush your tongue, the insides of your cheeks, and the roof of your mouth. It takes 2-3 minutes to remove the bacteria that live in plaque.
Clean between your teeth, where bacteria can hide. You can use a dental floss or water pick. You can also use the water pick to clean your tongue.
Watch what foods and drinks you consume. Sugars and carbohydrates help bacteria grow, reproduce and create the acid that eats through enamel to cause bacteria. Drink water to help dilute the sugars and brush after meals.
Visit Dr. Markowitz regularly. He can identify areas where bacteria are beginning to form cavities.
Dry Mouth
Do I have dry mouth?
Dry mouth is not a specific disorder, but actually a symptom of another issue. Common symptoms of dry mouth include:
A sticky, dry feeling in the mouth
Frequent thirst
Sores in the mouth; sores or split skin at the corners of the mouth; cracked lips
A dry feeling in the throat
A burning or tingling sensation in the mouth and especially on the tongue
A dry, red, raw tongue
Problems speaking or difficulty tasting, chewing, and swallowing
Hoarseness, dry nasal passages, sore throat
Bad breath
What causes dry mouth?
There are several causes of dry mouth. These include:
Side effect of certain medications
Side effect of certain diseases and infections
Side effect of certain medical treatments
Nerve damage
Dehydration
Surgical removal of the salivary glands
Lifestyle
Why is dry mouth a problem?
Besides causing the aggravating symptoms mentioned above, dry mouth also increases a person’s risk of gingivitis, tooth decay, and mouth infections, such as thrush. Dry mouth can also make it difficult to wear dentures.
How is dry mouth treated?
If you think your dry mouth may be caused by certain medications you are taking, consult your doctor. It’s possible he may be able to adjust the dose you are taking or switch you to a different drug that doesn’t cause dry mouth.
In addition, an oral rinse to restore mouth moisture. Dr. Markowitz may also prescribe Salagen, a drug that increases the natural production of saliva.
Gingivitis (gum disease)
What is gingivitis?
Simply put, gingivitis is inflammation of the gums. It is the initial stage of gum disease and the easiest to treat. The direct cause of gingivitis is plaque. If plaque is not removed by daily brushing and flossing, it produces toxins that can irritate the gum tissue, causing gingivitis. At this early stage in gum disease, damage can be reversed. If it’s left untreated, however, gingivitis can become periodontitis and cause permanent damage to your teeth and jaw.
How do I know if I have gingivitis?
Some signs include red, swollen, tender gums that may bleed when you brush and/or floss. Another sign is when your gums have receded (pulled away) from your teeth, giving the teeth an elongated appearance. Gum disease can cause pockets to form between the teeth and gums, where plaque and food debris collect. Some people experience bad breath or a bad taste in their mouth.
How can I prevent gingivitis?
Good oral hygiene is essential. Cleanings at Dr. Markowitz’s office are also extremely important because once the plaque hardens and builds up, becoming tarter, only our hygienist can remove it.
You can help gingivitis before it even develops by:
Proper brushing and flossing to remove plaque and debris and control tarter buildup.
Eating right to ensure proper nutrition for your jawbone and teeth.
Avoiding cigarettes and other forms of tobacco
Scheduling regular check ups with Dr. Markowitz
Jaw Disorders
What is TMJ?
TMJ disorders include a variety of conditions that cause tenderness and pain in the temporomandibular joint (TMJ). Your TMJ is the ball-and –socket joint on each side of your lower jawbone (mandible) joins the temporal bone of your skull.
Between 5% and 15% of people in the U.S. experience pain associated with TMJ disorders. Women are more likely then men to develop TMJ disorders.
In most cases, pain and discomfort associated with TMJ disorders can be alleviated with an appliance Dr Markowitz makes right in his office. However, more severe cases may need to be treated with surgical interventions. Let Dr. Markowitz evaluate your issues and tell you your options.
How can I tell if I have a TMJ disorder?
Signs and symptoms of TMJ disorders may include:
Pain or tenderness of your jaw
Aching pain in and around your ear
Difficulty chewing or discomfort while chewing
Aching facial pain
A clicking sound or grating sensation when opening your mouth or chewing
Locking of the joint, making it difficult to open or close your mouth
Headache
Uncomfortable bite
An uneven bite, because one or more teeth are making premature contact
You may feel pain or tenderness, even when you aren’t moving your jaw. But in most cases, the pain or tenderness worsens when you move your jaw.
Jaw clicking is common and doesn’t always signal a problem. If there’s no pain or limitation of movement associated with your jaw clicking, you might not have a TMJ disorder. Have Dr. Markowitz evaluate your symptoms.
How will Dr. Markowitz treat my TMJ disorder?
In some cases, the symptoms of TMJ disorder may go away without treatment. If they persist, Dr. Markowitz will most likely recommend one or more conservative, non-surgical treatments or behavioral interventions to alleviate pain. Dr. Markowitz may suggest the following treatments or interventions:
Breaking bad tension-related habits. Dr. Markowitz will ask you to be aware of your daytime habits, like clenching you jaw, grinding your teeth, or chewing on your lip or on objects. These habits need to be replaced with good jaw “posture”
Avoiding overuse of jaw muscles. Dr. Markowitz will ask you to change your diet choices or behaviors that over work or strain your jaw.
Stretching and massage. Dr. Markowitz will show you how to do exercises that stretch your jaw muscles and how to massage the muscles yourself.
Heat or cold. Applying warm, moist heat or ice to the side of your face may help you relax your muscles or alleviate pain.
Anti-inflammatory medications. To reduce inflammation and lessen pain, Dr. Markowitz may advise taking aspirin or ibuprofen.
Biteplate. If your TMJ is misaligned, Dr. Markowitz may recommend a plastic biteplate (splint), worn over your teeth, to help align your upper and lower jaws.
Night guard appliance. If you grind your teeth in your sleep, a night guard appliance, which can be soft or firm, is a device inserted over your teeth. It will prevent grinding and excessive wear of your teeth.
Tooth Sensitivity
What causes tooth sensitivity?
It occurs when the underlying layer of your teeth-the dentin-becomes exposed as a result of receding gum tissue (when the gums shrink away from the tooth exposing the root of the tooth). The roots, which are not covered by hard enamel, contain thousands of tiny tubules leading to the tooth’s nerve center (the pulp). These little tubules allow stimuli-for example, the hot, cold, or sweet food-to reach the nerve in your tooth, which results in the pain you feel.
There are many factors that may lead to development of tooth sensitivity, including:
Brushing too hard
Recessed gums
Gum disease
Cracked teeth
Teeth grinding
Tooth whitening products
Your age. Tooth sensitivity is highest between the ages of 25-30
Plaque build-up
Long-term use of some mouthwashes. Some over-the-counter mouthwashes contain acids that can worsen tooth sensitivity if you have exposed dentin (the middle layer of the tooth).
Acidic foods
Recent routine dental procedures. Sensitivity can occur following teeth cleaning, root planning, crown placement, and tooth restoration. Sensitivity caused by dental procedure is temporary and usually disappears in 4-6 weeks.
What can I do to reduce tooth sensitivity?
Maintain good oral hygiene
Use a soft bristled toothbrush
Use desensitizing toothpaste
Watch what you eat.
Use fluoridated dental products
Avoid teeth grinding
See Dr. Markowitz at regular intervals.
If you still have discomfort, talk to Dr. Markowitz. There may be some dental procedures that may help reduce sensitivity, including the use of:
White fillings (bonding) to cover exposed root surfaces
Fluoride varnishes applied to the exposed root surfaces
Dentin sealers applied to the exposed root surface
Mouth Sores
Anyone who has had a mouth sore knows it can be painful and can interfere with eating. Loose orthodontic wires, dentures that no longer fit or a sharp edge from a broken tooth or filling also can cause a mouth sore. They may also be cause by bacterial, viral or fungal infections, which may be the symptom of a systemic disorder or disease. Some of the most common mouth sores often associated with diseases and disorders are canker sores, cold sores, and candidiasis (thrush).
Canker Sores
Also called aphthous ulcers, are very common, but they are not contagious. They are small, creamy-white ulcers with a red border that are quite painful. They are often confused with cold sores. However cold sores usually occur outside the mouth while canker sores always occur in the mouth.
Canker sores usually heal in a week or two, but recurrent outbreaks are common. If you get one, avoid hot, spicy or acidic food for your comfort.
Cold Sores
Also called fever blisters or herpes simplex, are grape-like clusters of painful, fluid-filled blisters that erupt often around the lips. They are caused by herpes simplex virus type 1 and are very contagious.
The blisters sometimes appear after a fever, sunburn, skin abrasions or emotional upset. They usually heal in one to two weeks. Over–the-counter creams and prescription drugs may provide relief.
Candidiasis
It is a fungal infection that results in red-and-cream-colored patches that form on moist surfaces in the mouth and can be painful. The condition may cause difficulty in swallowing and change the sense of taste.
Candidiasis usually occurs in patients who are very young or elderly, in people debilitated by disease or in people who have improperly functioning immune systems. It could also result from antibiotic treatment.
Antifungal medications may be used to help manage or resolve the condition. Good oral hygiene is essential.
Periodontal Disease (periodontitis)
What is periodontal disease?
Gum diseases, including gingivitis and periodontitis, are serious infections that, if left untreated, can lead to tooth loss. Periodontal disease is a chronic bacterial infection that affects the gums and bone supporting the teeth.
This disease can affect one or many teeth. It starts when the bacteria in plaque causes the gums to be inflamed. In the mildest form of the disease, gingivitis, the gums get red and swollen. They also bleed very easily. The disease is almost never painful or even felt by the patient.
Untreated gingivitis almost always advances to periodontitist. Over time the plaque can spread and grow below the gum line. The toxins in plaque irritate the gums. It than stimulates a chronic inflammatory response in which the body in essence turns on itself, and the tissues and bone that support the teeth are broken down and destroyed. The gum separates from the tooth and creates pockets which harvest more bacteria and become infected. Eventually teeth will become loose and may have to be removed.
What causes periodontal disease?
The main cause of it is bacterial plaque, a sticky, colorless film that constantly forms on your teeth. The following are other factors that affect the health of your gums.
Smoking/Tobacco Use
Genetics
Pregnancy and puberty
Stress
Medications
Clenching or grinding your teeth
Diabetes
Poor nutrition
Diseases that interfere with the body’s immune system may worsen the condition of the gums
How will Dr. Markowitz treat my periodontitis?
Dr. Markowitz’s dental hygienist will give your teeth a thorough cleaning above and below the gums. The treatment is called scaling and root planning. For scaling, the hygienist uses instruments to scrape the tarter off teeth below the gum line. The next step, called planning, is a smoothing procedure to make sure there are no rough surfaces to continue irritating the teeth.
Dr. Markowitz or the hygienist will than administer Arestin, an effective antibiotic treatment. It comes in a powder form and is placed, painlessly, within the periodontal pockets. The powder is composed of little micro spheres that are filled with the antibiotic called minocycline, and they release the drug over time into the infected pocket, killing the bacteria that cause periodontal disease.
For more information on Arestin, please visit their website at www.arestin.com and click on the “for patients” tab.
Jaw Clenching or Grinding
This is also known as bruxism. It can be either clenching or grinding of the teeth, or both together. Dr. Markowitz will often recommend an appliance to prevent damage to your teeth, and stress reduction to change the behavior.
What kind of damage does bruxism cause?
Bruxism can lead to pain and cause damage to gums and teeth.
Sore facial muscles. The same muscles you use for chewing food are used when you grind. These muscles often feel sore or tender in the morning. It could make your jaw feel tight or cause pain on the sides of your mouth when it’s touched. It could manifest into an ear-ache, headache, or even neck pain.
Cosmetic damage. Bruxism can cause the teeth to be ground down becoming obviously shortened and creating cosmetic damage.
Sensitive teeth. As the enamel of the tooth is worn away by bruxism the underlying dentin layer of the tooth is exposed. This causes the tooth to become sensitive to cold, pressure, and other stimuli.
Fractured teeth and fillings. The high pressure created from bruxism can fracture teeth and crack fillings.
TMJ Damage
How will Dr. Markowitz treat my bruxism?
Dr. Markowitz can tell you if your symptoms are due to bruxism. In most cases, he will create a custom mouth guard for you to wear while you sleep. The mouth guard takes the punishment that your teeth would normally endure during your bruxism. This will minimize the damage caused by it.
Dr. Markowitz will also recommend reducing your alcohol intake since alcohol has been shown to worsen bruxism.
It is well known that stress and anxiety play a major role in causing bruxism. Dr. Markowitz may advise you on how to effectively manage the stress in your life. By carefully monitoring and controlling the stress you can often dramatically reduce bruxism.
Toothaches
What is a toothache?
The term “toothache” usually refers to pain around the teeth or jaw. In most cases, toothaches are caused by cavities, a cracked tooth, an exposed root, gum disease, disease of the jaw joint (TMJ), or spasms of the muscles used for chewing. A tooth ache can range from chronic and mild to sharp and excruciating. The pain may be aggravated by chewing or by heat or cold. An exam and dental x-rays from Dr. Markowitz can determine the cause and whether the toothache is being caused by a tooth or jaw problem.
Why should I take care of a toothache?
First off, it’s possible the toothache could be a sign of a non-dental problem, and not a problem associated with the tooth itself. If the problem is with the tooth, than early treatment is imperative because Dr. Markowitz wants you to keep as much original tooth structure as possible. A cavity caught early can just be filled. But if left untreated, can cause an abscess and need a root canal. An early abscess can be treated with a root canal instead of extracting the tooth. Extraction is always Dr. Markowitz’s last resort.
