By James J. Karam DDS, PC
December 07, 2017
Category: Oral Health
WhatYoucandotoEasethatBurningSensationinYourMouth

Have you ever felt a hot, burning sensation in your mouth—like it had been scalded—but you didn't eat or drink anything that could have caused it?

While you may think you’re hallucinating, there’s another possibility: Burning Mouth Syndrome (BMS). This condition, which can last for years, produces sensations in the mouth of not only scalding or burning, but also tingling, numbness and a decline in your ability to taste. Patients may feel it throughout their mouth or only in localized areas like the lips, tongue or inside the cheeks.

The exact cause of BMS is also something of a mystery. It’s been theoretically linked to diabetes, vitamin or mineral deficiencies and psychological problems. Because it’s most common among women of menopausal age hormonal changes have been proposed as a factor, although hormone replacement therapy often doesn’t produce any symptomatic relief for BMS.

To complicate matters, other conditions often share the condition’s effects, which need to be ruled out first to arrive at a BMS diagnosis. A feeling of scalding could be the result of mouth dryness, caused by medications or systemic conditions that inhibit saliva flow. Some denture wearers may display some of the symptoms of BMS due to an allergic reaction to denture materials; others may have a similar reaction to the foaming agent sodium lauryl sulfate found in some toothpaste that can irritate the skin inside the mouth.

If these other possibilities can be ruled out, then you may have BMS. While unfortunately there’s no cure for the condition, there are ways to lessen its impact. There’s even the possibility that it will resolve itself over time.

Until then, keep your mouth moist by drinking lots of water or using saliva-stimulating products, limiting alcohol, caffeinated drinks or spicy foods and refraining from smoking. If you’re taking medications that could cause dry mouth, speak with your physician about changing to an alternative. And try to reduce stress in your life through exercise, mindfulness practices or support groups.

While BMS isn’t considered harmful to your physical health it can make life less enjoyable. Careful symptom management may help improve your quality of life.

If you would like more information on Burning Mouth Syndrome, 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 “Burning Mouth Syndrome: A Painful Puzzle.”

JulianneHoughSharesaVideo-andaSong-AfterWisdomTeethComeOut

Once upon a time, celebrities tried hard to maintain the appearance of red-carpet glamour at all times. That meant keeping the more mundane aspects of their lives out of the spotlight: things like shopping, walking the dog and having oral surgery, for example.

That was then. Today, you can find plenty of celebs posting pictures from the dentist on social media. Take Julianne Hough, for example: In 2011 and 2013, she tweeted from the dental office. Then, not long ago, she shared a video taken after her wisdom teeth were removed in December 2016. In it, the 28-year-old actress and dancer cracked jokes and sang a loopy rendition of a Christmas carol, her mouth filled with gauze. Clearly, she was feeling relaxed and comfortable!

Lots of us enjoy seeing the human side of celebrities. But as dentists, we’re also glad when posts such as these help demystify a procedure that could be scary for some people.

Like having a root canal, the thought of extracting wisdom teeth (also called third molars) makes some folks shudder. Yet this routine procedure is performed more often than any other type of oral surgery. Why? Because wisdom teeth, which usually begin to erupt (emerge from beneath the gums) around age 17-25, have the potential to cause serious problems in the mouth. When these molars lack enough space to fully erupt in their normal positions, they are said to be “impacted.”

One potential problem with impacted wisdom teeth is crowding. Many people don’t have enough space in the jaw to accommodate another set of molars; when their wisdom teeth come in, other teeth can be damaged. Impacted wisdom teeth may also have an increased potential to cause periodontal disease, bacterial infection, and other issues.

Not all wisdom teeth need to be removed; after a complete examination, including x-rays and/or other diagnostic imaging, a recommendation will be made based on each individual’s situation. It may involve continued monitoring of the situation, orthodontics or extraction.

Wisdom tooth extraction is usually done right in the office, often with a type of anesthesia called “conscious sedation.”  Here, the patient is able to breathe normally and respond to stimuli (such as verbal directions), but remains free from pain. For people who are especially apprehensive about dental procedures, anti-anxiety mediation may also be given. After the procedure, prescription or over-the-counter pain medication may be used for a few days. If you feel like singing a few bars, as Julianne did, it’s up to you.

If you would like more information about wisdom tooth extraction, please call our office to arrange a consultation. You can learn more in the Dear Doctor magazine articles “Wisdom Teeth” and “Removing Wisdom Teeth.”

By James J. Karam DDS, PC
November 07, 2017
Category: Dental Procedures
HereisHowYoucanImproveYourWeddingDaySmile

Congratulations—you’re engaged! It’s a stupendous (and hectic) time in your life as you plan your upcoming wedding.

You want to look your best for the big day—which means you may be dieting, exercising or making changes to your hairstyle and makeup. Be sure, though, to consider another important part of your appearance—your teeth and gums. Here are a few options that could help your wedding day smile shine even more.

Cleanings and whitening. While dental cleanings are primarily about removing disease-causing plaque and tartar they can also give your teeth that clean and polished look. And if you want an extra boost in brightness, consider whitening—we may be able to lighten up your teeth’s stain-induced dullness.

Bonding. If your teeth have slight imperfections—chipping, slight gaps or staining that doesn’t respond well to whitening, consider bonding techniques to repair or cover these defects. Composite resin is a dental material that can be shaped and bonded to teeth to reform a deformed tooth—and with color matching as well. For more extensive defects you can cover the front of imperfect teeth with bonded porcelain veneers or completely cap a tooth with a custom crown.

Tooth restorations. If you have missing teeth marring your smile, you have several options. The top choice: dental implants, which replaces the root of the tooth and will be able to have a crown attached to it. An implant can thus restore both better function and appearance. For more affordable options, you can also turn to fixed bridges or removable dentures. The latter can be custom designed to replace all the teeth on a jaw arch or just a few in different locations.

Gum enhancements. Teeth aren’t the only part of your smile that might need a helpful touch—your gums’ appearance might also be a problem. There are cosmetic procedures including plastic surgery and tissue grafting that can help correct overly prominent “gummy” smiles or, at the other end of the spectrum, longer appearing teeth because of gum recession.

Orthodontics. If you have extended time before the wedding date, we may be able to correct crooked teeth or a poor bite (malocclusion) that’s adversely impacting your smile. In some cases, you may be able to choose clear aligners, removable plastic trays that are hardly noticeable to others, over more visible braces to correct your bite.

If you would like more information on cosmetic dentistry for lifetime events, please contact us or schedule an appointment for a consultation.

By James J. Karam DDS, PC
October 23, 2017
Category: Oral Health
Tags: pregnancy   dental care  
FAQDentalCareDuringPregnancy

Pregnancy is a very special and exciting time for expectant women and their families. At this time, many moms-to-be make careful choices to try and do what’s best for themselves and their babies. Wondering what’s the right way to take care of your oral health when you’re expecting? Here are answers to a few of the most common questions about dental care during pregnancy.

Q: Does pregnancy make a woman more susceptible to dental problems?
A: Yes. Pregnancy causes big changes in the levels of certain hormones, and these in turn have a powerful influence on your body. For example, many expectant moms experience food cravings and morning sickness at certain times. Changing hormone levels can also affect your oral health in various ways, including making your gums tender, swollen, and highly sensitive to the harmful bacteria in plaque.

Q: What are “pregnancy tumors” in the mouth?
A: These are benign (non-cancerous) overgrowths of tissue that sometimes develop on the gums during the second trimester. Often appearing between the teeth, these swollen reddish growths are thought to be caused by plaque bacteria. They sometimes go away on their own when pregnancy is over, but may be surgically removed if they don’t.

Q: Is it normal to have bleeding gums during pregnancy?
A: It’s not uncommon, but it does indicate that you need to pay careful attention to your oral hygiene at this time. Pregnancy hormones can cause the tiny blood vessels in your gums to become enlarged; when plaque bacteria are not effectively removed from the mouth, the gums may become inflamed and begin to bleed. This condition is often called “pregnancy gingivitis.” If left untreated, it can progress to a more serious form of gum disease called periodontitis. That’s one reason why regular brushing and flossing are so important during pregnancy — as are routine professional cleanings.

Q: Is it safe to have dental cleanings and checkups during pregnancy?
A: Yes; in fact, it’s a very good idea to have at least one. Studies have shown that women who receive dental treatment during pregnancy face no more risks to their developing babies than those who don’t. On the other hand, poor oral health is known to cause gum disease, and is also suspected of being linked to adverse pregnancy outcomes. Routine dental exams and professional cleanings can help you maintain good oral health and avoid many potential problems during this critical time.

Q: Should I postpone more complicated dental work until after I have a baby?
A: It depends. A study recently published in the Journal of the American Dental Association found it was safe for pregnant women to have routine procedures like fillings, root canals, and extractions, even if they require local anesthesia. So treatments that are essential to an expectant mother’s health shouldn’t be put off. However, if you’re planning to have cosmetic dental work, it might be best to err on the side of caution and wait until after your baby is born.

Have more questions about oral health during pregnancy? Contact our office or schedule a consultation — and be sure to let us know that you are pregnant, so we can make sure you get the extra attention you need. You can learn more in the Dear Doctor magazine article “Pregnancy and Oral Health.”

By James J. Karam DDS, PC
October 15, 2017
Category: Oral Health
Tags: tooth pain  
WhyYourTeethHurtWillDetermineHowWeTreatThem

Your teeth and gums have a highly sensitive network of nerves. But while it can signal even the most subtle discomfort we may not be able to identify the cause with pinpoint accuracy. As a result, tooth pain could indicate more than one kind of problem including a decayed tooth, root sensitivity, infected gum tissues (like an abscess) or a dying pulp signaled by diseased nerve tissue inside the tooth.

On the other hand, not all tooth pain is the same: it can be dull or sharp, continuous or intermittent. It can feel like a constant, throbbing ache or a sharp wince when you eat or drink something cold or hot, or when you bite down. These differences could point our diagnostic examination in the right direction.

For example, sharp, throbbing pain could indicate deep tooth decay, especially if it suddenly stops. That would likely mean the nerves within the tooth pulp under attack by the infection have died and can no longer transmit pain. The infection, on the other hand is still very much active — this usually requires a root canal treatment (cleaning out the pulp and root canals of diseased and dead tissue and filling the empty spaces) if we’re to save the tooth.

If, however, you’re experiencing sensitivity from temperature or pressure, we could be facing at least a couple of scenarios. For one, your tooth could be fractured. More likely, though, periodontal (gum) disease triggered by bacterial plaque has caused the gum tissues to shrink back (recede) from the affected teeth so that the sensitive dentin layer is exposed and no longer protected by the gum tissue.

If we diagnose gum disease, we’ll need to aggressively remove bacterial plaque from all tooth and gum surfaces. This procedure might require more than one appointment and the possibility of surgery if we encounter deep pockets of infection, especially around the roots. If gum recession is severe you may also need grafting surgery to replace the missing gum tissue or to re-cover the exposed areas of your teeth.

So, knowing the source of tooth pain will direct the course of treatment to follow. With proper treatment, though, the chances are good we can not only restore your teeth and gums to optimum health but we can end the pain.

If you would like more information on treating tooth pain, 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 “Confusing Tooth Pain.”





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