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Posts for category: Dental Procedures

By Lynda V. Butler, DDS
February 19, 2020
Category: Dental Procedures
Tags: facial pain  
FacialNervePaincanbeReducedwiththeRightTreatmentApproach

Our nerves serve a vital purpose, alerting us to bodily discomfort, injury or disease — we couldn’t remain in good health for long without them. But when they malfunction due to genetics or disease, they can themselves become a source of pain and discomfort.

One such nerve disorder that affects the face is known as trigeminal neuralgia (TN) or tic douloureaux (from the French for “painful”). The nerves in question are the trigeminal, a pair that travel up from the brain stem through the skull into each side of the face where they each branch into the upper, middle and lower parts of the face and jaw. The pain can radiate from one or more of these branches.

TN is characterized by recurring episodes of brief but severe pain with accompanying muscle spasms. It may begin as a short twinge recurring over weeks, months or years before becoming increasingly painful. The slightest actions can trigger a painful episode: chewing, speaking, shaving or even the wind blowing on your face.

While it may be hard to determine its exact cause, it often seems to result from an artery or vein pressing on the nerve, causing it to signal pain at the slightest stimulation and then failing to stop transmitting when the stimulation is removed. It’s also associated with other inflammatory disorders like multiple sclerosis where the protective insulation around a nerve is damaged.

Before receiving treatment you should undergo a complete examination to rule out any other facial pain causes like temporomandibular (jaw joint) disorders or a dental abscess. You may also need to undergo a neurological examination and possible MRI imaging to pinpoint the exact cause, like a tumor or blood vessel pressing on the nerve.

Although the condition may not be curable, there are several effective management treatments. The more conservative approaches usually involve medications to block the nerve’s pain signals or decrease its abnormal firing. If this isn’t sufficient to diminish symptoms, there are surgical options: passing a thin needle through the nerve to selectively prevent fibers from firing, or moving aside a blood vessel pressing on it. High-dose targeted radiation may also be effective, especially with older patients.

The best treatment approach will depend on the exact cause, your age and overall health. Whatever the approach, you can gain significant relief from the pain of TN.

If you would like more information on facial nerve disorders, please contact us or schedule an appointment for a consultation.

NeedaRootCanalHeresaStep-by-StepGuideonWhattoExpect

You’ve recently learned one of your teeth needs a root canal treatment. It’s absolutely necessary: for example, if you have decay present, it will continue to go deeper within the tooth and it will spread to the roots and bone and could ultimately cause you to lose your tooth. Although you’re a little nervous, we can assure you that if we’ve recommended a root canal treatment, it’s the right step to take for your dental health.

There’s nothing mysterious — or ominous — about a root canal. To help ease any fears you may have, here’s a step-by-step description of the procedure.

Step 1: Preparing your mouth and tooth. We first take care of one of the biggest misconceptions about root canals: that they’re painful. We completely numb the tooth and surrounding tissues with local anesthesia to ensure you will be comfortable during the procedure. We isolate the affected tooth with a thin sheet of rubber or vinyl called a rubber dam to create a sterile environment while we work on the tooth. We then access the inside of the tooth — the pulp and root canals — by drilling a small hole through the biting surface if it’s a back tooth or through the rear surface if it’s in the front.

Step 2: Cleaning, shaping and filling the tooth. Once we’ve gained access we’ll clear out all of the dead or dying tissue from the pulp and root canals, and then cleanse the empty chamber and canals thoroughly with antiseptic and antibacterial solutions. Once we’ve cleaned everything out, we’ll shape the walls of the tiny root canals to better accommodate a filling material called gutta-percha, which we then use to fill the canals and pulp chamber.

Step 3: Sealing the tooth from re-infection. Once we complete the filling, we’ll seal the access hole and temporarily close the tooth with another filling. Later, we’ll install a permanent crown that will give the tooth extra protection against another infection, as well as restore the tooth’s appearance.

You may experience some mild discomfort for a few days after a root canal, which is usually manageable with aspirin or ibuprofen. In a week or so, you’ll hardly notice anything — and the tooth-threatening decay and any toothache it may have caused will be a distant memory.

If you would like more information on root canal treatments, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “A Step-by-Step Guide to Root Canal Treatment.”

HowShawnMendesandMileyCyrusGotTheirStellarSmiles

The 2019 Grammy Awards was a star-studded night packed with memorable performances. One standout came from the young Canadian singer Shawn Mendes, who sang a powerful duet of his hit song "In My Blood" with pop diva Miley Cyrus. But that duo's stellar smiles weren't always quite as camera-ready as they looked that night.

"I had braces for four and a half years," Mendes told an interviewer not long ago. "There's lots and lots and lots of photo evidence, I'm sure you can pull up a few." (In fact, finding one is as easy as searching "Sean Mendes braces.")

Wearing braces puts Mendes in good company: It's estimated that over 4 million people in the U.S. alone wear braces in a typical year—and about a quarter of them are adults! (And by the way: When she was a teenager, Miley Cyrus had braces, too!)

Today, there are a number of alternatives to traditional metal braces, such as tooth-colored braces, clear plastic aligners, and invisible lingual braces (the kind Cyrus wore). However, regular metal braces remain the most common choice for orthodontic treatment. They are often the most economical option, and can be used to treat a wide variety of bite problems (which dentists call malocclusions).

Having straighter teeth can boost your self-confidence—along with helping you bite, breathe, chew, and even speak more effectively. Plus, teeth that are in good alignment and have adequate space in between are easier to clean; this can help you keep your mouth free of gum disease and tooth decay for years to come.

Many people think getting braces is something that happens in adolescence—but as long as your mouth is otherwise healthy, there's no upper age limit for orthodontic treatment. In fact, many celebrities—like Lauren Hutton, Tom Cruise and Faith Hill—got braces as adults. But if traditional braces aren't a good fit with your self-image, it's possible that one of the less noticeable options, such as lingual braces or clear aligners, could work for you.

What's the first step to getting straighter teeth? Come in to the office for an evaluation! We will give you a complete oral examination to find out if there are any problems (like gum disease or tooth decay) that could interfere with orthodontic treatment. Then we will determine exactly how your teeth should be re-positioned to achieve a better smile, and recommend one or more options to get you there.

If you have questions about orthodontic treatment, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “The Magic of Orthodontics” and “Lingual Braces: A Truly Invisible Way to Straighten Teeth.”

By Lynda V. Butler, DDS
December 21, 2019
Category: Dental Procedures
Tags: TADs  
AnchorageDevicesEnableGreaterPrecisionDuringOrthodonticTreatment

As a basic orthodontic appliance, braces are what allows us to move teeth into better positions to improve a person’s bite. In certain cases, though, this treatment application gets a little assistance from Temporary Anchorage Devices (TADs) to improve accuracy and reduce treatment time.

Braces take advantage of our teeth’s natural ability to move. Teeth are held in place within the bone by the periodontal ligament, an elastic tissue that attaches to the teeth with microscopic fibers secured by a hardened substance called cementum. The periodontal ligament is constantly remodeling in response to changes in the mouth. As pressure is placed on a tooth, new bone, ligament and cementum are formed on the “pulling” side of the tooth; on the other side, the bone and ligament dissolve (resorb), allowing the tooth to move in that direction.

Braces allow this natural process to occur with controlled forces applied by thin flexible wires threaded through the small brackets attached to the front of the teeth and then affixed or “anchored” to other teeth. By attaching the teeth to the other teeth by wires running through all the brackets, “anchorage” is created to allow teeth to be moved where the dentist wants them to go. By adjusting the tension on the wires, we can apply light but constant pressure on the “unanchored” teeth to move them into a new desired position.

Teeth we do not want to move are referred to as the anchorage for teeth we do want to move. If, however, the situation calls for more precise isolation of teeth to be moved, TADs can be very useful. TADs are mini-implants imbedded in the bone to serve as anchorage at strategic locations in the mouth. In this way, the group of teeth to be moved receives forces that are applied through the additional anchorage provided by the TADs. That “tension” or “pressure” is applied only to them and not to adjacent teeth that should not move. This increases efficiency for tooth movement and helps reduce the treatment time.

TADs can be placed using local anesthesia and with little discomfort, and are removed when orthodontic treatment is completed. Although the procedure is pretty straightforward, it does require collaboration between orthodontist and surgeon to ensure correct positioning.

In the end, TADs increase our ability to control the forces that move teeth during orthodontic treatment. This lessens discomfort for the patient and helps ensure the end result — a more functional bite and a transformed smile.

If you would like more information on the use of TADs and other orthodontic appliances, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine article “What are TADs?

By Lynda V. Butler, DDS
December 11, 2019
Category: Dental Procedures
26MillionFansLikeJustinBiebersChippedTooth

Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”

Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.

Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:

A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.

If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.

Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.

Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.

Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.

If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”



Lynda V. Butler, DDS

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