By Edward Joseph, D.D.S.
August 24, 2020
Category: Oral Health
Tags: toothache  
YourToothacheMightSignalaProblemOtherThaninYourMouth

You expect a decayed tooth, a fracture or a gum infection to be the cause for that toothache causing you grief. Sometimes, though, the answer may be “none of the above”—there's nothing wrong going on in your mouth to cause the pain.

You pain is real—but its source is elsewhere in the body, a situation known as referred pain. It's important to find out the pain's true source to determine what kind of treatment you'll need to alleviate it.

Here are some of the likely candidates for a “toothache” that's not a toothache.

Facial nerves. Tooth pain may be associated with trigeminal neuralgia, a misfiring disorder of the trigeminal nerves that course through either side of the face. The nerve is divided into three branches, two of which are located in the upper face and one in the lower jaw. Because they're interconnected, a problem with one of the branches in other parts of the face could be felt in the branch around the jaw.

Jaw joints. Temporomandibular Joint Disorders (TMD) can cause pain in the pair of joints that connect the lower jaw to the skull. The joints can become inflamed due to stress or trauma and the associated muscles begin spasming, causing severe pain. Because of their proximity to the teeth, the pain from the joints can radiate into the dental area and mimic a toothache.

Ear or sinus infections. Both the ears and the maxillary sinus are subject to infections that can cause severe pain and pressure. With the close proximity of both the ears and the sinus to the upper jaw, it's quite possible for pain originating in these structures to be felt within the mouth.

These are only a few of the possibilities that also include migraines, shingles, fibromyalgia and even vitamin deficiencies. As such, your dentist or physician may need to do a little detective work to locate the true cause. But the effort to locate where your mouth pain is actually coming from will help ensure you get the right treatment to give you lasting relief.

If you would like more information on referred 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 “Referred Pain: When a Toothache Is Not Really a Toothache.”

By Edward Joseph, D.D.S.
August 19, 2020
Category: Oral Health
Tags: oral health   bad breath  
4SimpleThingsYouCanDotoStopBadBreath

When they weren't building pyramids or wrapping mummies, the ancient Egyptians mixed herbs and spices with a little honey to make small lozenges. Their purpose: to fight halitosis, that perennial scourge of polite society. More specifically, they were the first known breath mints.

Just like our ancient forebears, we're still trying to stop bad breath—to the tune of $12 billion annually for breath-freshening products. For the most part, though, fresher breath is still largely the byproduct of dedicated oral care. In recognition of National Fresh Breath Day this August 6th, here are 4 simple things you can do to help eliminate embarrassing bad breath.

Remove dental plaque. Mouth bacteria proliferating within a thin buildup of food particles is called dental plaque—the main culprit in 85—90% of bad breath cases. These bacteria can emit volatile sulfur compounds (VSCs), which have a characteristic rotten egg smell. You can reduce bacteria and their foul odors by removing plaque with daily brushing and flossing and twice-a-year dental cleanings.

Boost your saliva. An inadequate flow of saliva, often a side effect of certain medications, can leave your mouth dry and susceptible to bacterial growth and subsequent bad breath. You can increase saliva flow by drinking more water, using saliva-boosting aids, or speaking with your doctor about alternative medications with less of a dry mouth side effect.

Brush your tongue. Some people find their tongue is “Velcro” for tiny food particles, which attract bacteria. It's always a good idea to brush your tongue (especially toward the back) to loosen and remove any clinging food particles. If it continues to be a problem, you can also employ a tongue scraper for a more thorough tongue cleaning.

Get a checkup. Although bacterial growth from inadequate hygiene is the usual cause for bad breath, it isn't the only one. Dental diseases like tooth decay or gum disease can also create unpleasant mouth odors, as well as serious conditions like diabetes, kidney infections or certain cancers. If your bad breath persists despite diligent hygiene, see us or your doctor for a more comprehensive exam.

During our long war with halitosis, we've learned a thing or two about its causes. We've also learned that practicing good oral habits is the best thing you can do to beat bad breath.

If you would like more information about controlling bad breath, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Bad Breath: More Than Just Embarrassing.”

TalkWithYourDentistAboutAntibioticTherapyBeforeImplantSurgery

Dental implants are far and away the most “tooth-like” restoration available today for missing teeth. Not only do they look real, they also mimic dental anatomy in replacing the tooth root.

To install an implant, though, requires a minor surgical procedure. And, as with any surgery, that includes a slight risk for a post-surgical infection. For most patients this isn't a major concern—but it can be for people with certain medical conditions.

One way to lessen the risk for implant patients whose health could be jeopardized by an infection is to prescribe a prophylactic (preventive) antibiotic before implant surgery. The American Dental Association (ADA) recommends the measure for patients with artificial heart valves, a history of infective endocarditis, a heart transplant and other heart-related issues.

In the past, their recommendation also extended to people with joint replacements. But in conjunction with the American Academy of Orthopedic Surgery (AAOS), the ADA downgraded this recommendation a few years ago and left it to the physician's discretion. Indeed, some orthopedic surgeons do recommend antibiotic therapy for patients before surgical procedures like implantation for up to two years after joint replacement.

These changes reflect the ongoing debate over the proper use of antibiotics. In essence, this particular argument is over risks vs. benefits: Are pre-surgical antibiotics worth the lower infection risk for patients at low to moderate risk in return for increased risk of allergic reactions and other side effects from the antibiotic? Another driver in this debate is the deep concern over the effect current antibiotic practices are having on the increasing problem of antibiotic-resistant bacteria.

As a result, dentists and physicians alike are reevaluating practices like prophylactic antibiotics before procedures, becoming more selective on who receives it and even the dosage levels. Some studies have shown, for example, that a low 2-gram dose of amoxicillin an hour before the procedure can be effective with much lower risks for side effects.

If you're considering dental implants and you have a medical condition you think could be impacted by the procedure, discuss the matter with your dentist and physician. It may be that pre-surgical antibiotics would be a prudent choice for you.

If you would like more information on getting dental implants, 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 “Implants & Antibiotics.”

StopPlaqueBuildupAroundYourImplant-SupportedBridgeWithFlossing

Losing your teeth can be a traumatic experience with serious consequences for your overall health. Fortunately, you have great options for replacing lost teeth that can restore both appearance and dental function.

One such option is a fixed bridge supported by dental implants. While implants are best known for single tooth replacement, they can also be used with other restorations like bridges. In this case, the bridge is screwed into a few well-placed implants to support it.

Implants can provide bridges with more security and support, and without the need to alter adjacent teeth that are commonly used for traditional tooth replacement. They may also slow or stop bone loss because the titanium in implants naturally attracts bone cells that grow and adhere to its surface and provide stimulation to the bone cells during function.

Because of these benefits an implant-supported bridge could be a life-changer that provides years of satisfaction. But we can’t simply “set them and forget them”: They require dedicated oral hygiene just like natural teeth.

While the bridge materials and implants themselves are in no danger from disease, the same can’t be said for the implant’s supporting gums and bone. Dental plaque, the main driver in gum disease, can place these tissues at risk for infection that could eventually lead to implant failure.

It’s important, then, for you to floss around your new implants to remove any plaque. This differs from regular flossing in which you work the thread between teeth. Instead, you’ll have to maneuver the floss between the bridge and gums with the help of a floss threader, a small slender tool with a loop at one end and a stiffer plastic edge at the other (similar to a sewing needle).

To use it, first run 18” of floss through the loop until you get equal lengths and then work the tail of the floss threader between the bridge and gums while holding one end of the floss. Once through, you pull the floss threader through so that the floss is on either side of the bridge. Then grab each end of the floss and pull it snug to floss up and down one side of the implant. Go to the next side and repeat this procedure for all the implants.

As an alternative, you could use an oral irrigator, which emits a pulsating spray of water to loosen and wash away plaque. Either way, though, it’s important to floss around implants to get the most life out of your bridge.

If you would like more information on proper care for implant-supported restorations, 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 “Oral Hygiene for Fixed Bridgework.”

By Edward Joseph, D.D.S.
August 04, 2020
Category: Oral Health
Tags: oral hygiene  
AWordtoYoungAdultsBrushingandFlossingareKeytoaHealthyMouth

Keeping your teeth and gums healthy doesn't require an elaborate plan. It's simple: Besides twice-a-year dental visits, the most important thing you can do is brush and floss every day to remove accumulated dental plaque.

The bacteria that live and breed in this thin biofilm is the main catalyst for both tooth decay and gum disease, the top two diseases that endanger teeth. Brushing and flossing removes this buildup and thus reduces the long-term risk for either disease.

Unfortunately, the message on these important hygiene tasks hasn't resonated with “Millennials,” the first generation to reach adulthood in the 21st Century and new millennium. One recent survey of 2,000 members of this age group found only about 30% brushed their teeth at least once a day, with many skipping the task for two days at a time.

If brushing has taken a beating among millennials, you can well imagine the state of flossing. Unfortunately, the news media has helped this along: Just a few years ago, the Associated Press reported a study that concluded flossing's role as a dental disease deterrent hadn't been proven. A follow-up study a year or two later by the University of North Carolina pushed back on the original AP story with findings of lower risk of tooth loss among flossers than non-flossers.

This decline in oral hygiene practices among millennials has had an unsurprisingly negative effect. Recent statistics indicate that one in three people between the ages of 18 and 34 have some form of untreated tooth decay. As this generation ages this may inevitably result in more extensive dental treatment and higher rates of tooth loss unless the trend toward hit and miss dental care makes a complete U-turn.

The good news is that it may not be too late for many of those slacking on daily care. All that's needed is to heed the same dental advice their grandparents and parents were given: Brush twice and floss once every day.

No matter what your age, consistent daily brushing and flossing still remains essential to keeping potential dental disease at bay. These twin hygiene tasks remain the solution to good dental health throughout your life.

If you would like more information on best oral hygiene practices, please contact us or schedule an appointment for a consultation.





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Burbank, CA Dentist
Edward C. Joseph, D.D.S.
2701 West Alameda Ave, Suite #403
Burbank, CA 91505
(818) 842-7628

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