“About six months ago I went to the dentist and he did some kind of drilling. He put a [filling] behind my tooth in the front row on the bottom.   After getting the drilling done, I couldn’t eat or drink anything! It hurt so bad. A month later the pain was basically gone. It’s starting to come back again. But even worse[than before]. I don’t want to go through anything painful, (filling, etc,.) The tooth mostly hurts on the top and whenever I drink cold milk or hot coffee. Or eat something hot or cold. I am totally scared of the dentist. I have got a filling before, they numbed me and stuff, but it still hurt! I DON’T WANT TO GET ANOTHER ONE  HELP ME!”

Answer:

There are several reasons why dental drilling may be necessary. These include:

• Dental drilling to remove decay and then place a filling in that area
• Dental drilling to prepare a tooth or teeth for a cap (crown)
• Dental drilling to clean and fill the pulp if a tooth needs root canal therapy

The description you gave sounds like you received a front tooth filling. Sensitivity to cold sometimes indicates the beginning of tooth decay. There are two areas of a tooth that a dentist may have to go through when doing dental drilling, in order to treat your front tooth cavity. These are enamel (which is the outside area, what you see when you look at your teeth) and dentin (which is directly below the enamel). Dentin has holes in it and fluid which when disturbed carries pain sensations to the pulp (the center of the tooth that has nerves and blood vessels).

Reasons that you may have a tooth sensitive to cold include:

• A tooth with a cavity/decay. Decay that may go deep into dentin and be the cause of a tooth sensitive to cold
• Filling is close to the pulp. A filling that is placed in the area where the decay has been removed, if the decay was deep. This sometimes results in a tooth that is sensitive to cold, and may be prevented by placing a dental liner over the dentin before filling the tooth.

From the details of your question, your tooth pain that occurred after your filling may have been due to the fact that your front tooth cavity was deep and close to the pulp.

What is a Solution to Pain After a Filling?

Tooth pain after a filling is not at all uncommon, however prolonged pain may be an indication that a liner may have helped. A dental liner is a thin layer of material that a dentist places under the filling so that your tooth won’t be sensitive to temperature.  It insulates the nerve of the tooth and protects it.  It would be a good idea to get a new radiograph (x-ray) of the tooth to see if there are other issues, and have it addressed from there on.  Your dentist may choose to either re-do the filling, or if the decay is deep, perform a root canal.

Remember, don’t allow your dental fear to stop you from taking care of your oral health. No dental treatment should be painful.  If you feel any pain during a procedure, don’t hesitate to let your dentist know that you need more anesthesia.  We hope this helps you!

“I am 13 yrs old. While playing my front upper incisors they broke in such a way the joint part broke giving “V”shape for the  front teeth.{small part only} please suggest what should be done to correct this ? Are dental caps[crowns] useful in this case.”

Answer:

Broken Front Teeth

Broken incisors are probably the most common complaint of a broken tooth after sporting activities. When teeth break as you’ve described, there’re three ways the fracture can occur (please read our Tooth Anatomy article for an understanding of tooth structure). This is referred to as an Ellis fracture.  Fractured teeth according to the Ellis classification are described as:

• A fracture involving only enamel (Ellis Class 1 fracture)
• A fracture involving enamel and dentin only (Ellis Class 2 fracture)
• A fracture involving enamel, dentin and pulp (Ellis Class 3 fracture)

Treatment for Broken Teeth

A dentist will need to examine your teeth and take dental x-rays to determine the extent of the damage and the necessary treatment. Your treatment will undoubtedly be based on your tooth fracture classification. Possible treatment options (depending on the extent of the fracture, also assuming that the teeth haven’t moved out of place) include:

• Restoring the teeth using dental composite ( a type of dental filling that has the same shade as normal teeth)
• Placing dental crowns (also called dental caps) over the teeth
• Doing a root canal treatment on the teeth (if the pulp is exposed), then placing dental crowns.

Sometimes when teeth fracture as you describe, there is tooth movement in the sockets, and a tooth or teeth may need to be moved back into placed using orthodontic treatment. Orthodontics involves moving teeth (and sometimes jaw movement also) to put teeth or jaws into proper position or alignment. Most people are familiar with orthodontic treatment from having or seeing other people with braces.

Please speak with you parents/guardians about seeing a pediatric dentist (a dentist who specializes in treating kids, including adolescents) or family general dentist as soon as possible. This is necessary so that you can be examined fully and the proper treatment given.

Good luck!

About six months ago I went to the dentist and he did some kind of drilling.  After getting the drilling done, I couldn’t eat or drink anything! It hurt so bad. A month later the pain was basically gone.  It’s starting to come back again. But even worse. I don’t want to go threw anything painful, (filling, etc,.) I really hope this isn’t anything bad because the tooth mostly hurts on the top and whenever I drink cold milk or hot coffee. Or eat something hot or cold. I am totally scared of the dentist. I have got a filling before, they numbed me and stuff, but it still hurt! I DON’T WANT TO GET ANOTHER ONE  HELP ME!

Answer:

Reasons for a Filling or Crown

There are several reasons why dental drilling may be necessary. These include:

• Dental drilling to remove decay and then place a filling in that area
• Dental drilling to prepare a tooth or teeth for a cap (crown)
• Dental drilling to clean and fill the pulp if a tooth or teeth need root canal therapy

The description you gave sounds like a front tooth cavity. Sensitivity to cold sometimes indicates the beginning of tooth decay. There are two areas of a tooth that a dentist may have to go through when doing dental drilling in order to treat your front tooth cavity.

These are:

• Enamel -  which is the outside area, what you see when you look at your teeth
• Dentin – located directly below the enamel.  Dentin has holes in it with fluid located inside.  When this fluid is disturbed, it carries pain sensations to the pulp (the center of the tooth that has nerves and blood vessels).  This is what happens when teeth ache (or a single pain in tooth).

Tooth Sensitivity

Reasons that you may have a tooth sensitive to cold include:

• A tooth with a cavity/decay. The decay may go deep into the dentin and be the cause of your tooth sensitivity (caries/decay is usually the main culprit when teeth ache).

• A filling that has been placed in an area of deep decay.  If the amount of caries is extensive, the drilling necessary may be more than if there were less caries. This sometimes results in a tooth that is sensitive to cold, and may be prevented by having your dentist place a dental liner over the dentin before filling the tooth.

From the details of your question, your tooth pain that occurred after your filling may have been due to the fact that your front tooth cavity was deep and close to the pulp. Tooth pain after a filling is not at all uncommon, however prolonged tooth pain may be an indication that a liner may have helped. It would be a good idea to get a new radiograph (x-ray) of the tooth to see if there are other issues, and have it addressed from that point.

Also, do not hesitate to let your dentist know if the filling hurts during the procedure.  You should be completely anesthetized and should not feel anything.  You run the show, and you can stop if necessary.

Remember, don’t allow your dental fear to stop you from taking care of your oral health.

We hope this helps you!

I chew gutkha [and] that’s why my teeth have turned brown.  Please suggest any whitening tooth paste.  I am from India.

Answer:

Gutkha is a concoction of several herbs, including tobacco, and is popularly sold in India and several other countries.  Unfortunately, gutkha severely stains teeth.  Depending on where the gutkha is held in the mouth, for example under the tongue or behind the teeth, the staining can be more severe in that particular area.

Treating Gutkha Tooth Staining

The good news is that the staining is temporary and can be easily removed.  However, a semi-harsh abrasive, like pumice, will need to be used.  This can best be accomplished by visiting the dentist for a cleaning/prophylaxis.  It may be possible to remove the staining with brushing, but believe us, it will take A LOT of work on your behalf to remove all of the stain.  Also, if you brush your teeth too hard, you run the risk of removing enamel and other vital tooth structure.  So though a slight cost is attached, we believe the best and easiest way to remove the stain is to go in for a quick cleaning.

Good luck and we hope this helps

SaveMySmile Team

I got into a fight on New Years eve, and took a pretty good punch to the mouth. My gums were bruised, and the gum on my right front tooth receded so that part of the root is visible.

Any help would be greatly appreciated, thanks.

Answer:

Well there are a couple of things to take into consideration when looking at your scenario.  For starters, is the tooth mobile?  This plays a HUGE role as to whether the tooth will “heal” or not.  If mobile, the tooth may need to have a splint attached by the dentist to immobilize the tooth so that healing can begin to occur.

We will answer your questions under the assumption that the tooth is not mobile.

Will it heal?

Yes and no.  Yes in that the periodontal ligaments (the fibers that attach the tooth to the socket and bone) have undergone extensive trauma and will begin to reattach so that the tooth can function normally.  No, in that the gums that have receded will not grow back over the exposed root without assistance from the dentist.  What will actually happen is that the pdl fibers will reattach on the remaining gingiva (gums).

Will I require dental surgery?

Yes.  You will need something referred to as periodontal plastic surgery (believe us, sounds much more complicated that what it actually is).  The dentist uses a free gingival graft or connective tissue graft to cover the area.  This means that he/she will remove some gum tissue from one part of your mouth, and place it over the area of recession in order to stimulate growth.

Do I need to avoid smoking?

Yes is an understatement!!  Smoking severely compromises the amount of blood supply to your gums.  Insufficient blood supply=delayed healing!

Will it get infected if I don’t take care of it?

Let’s consider the anatomy of teeth when looking at this question.  Unlike the crown of the tooth, which is covered by enamel, the root of the tooth is covered by a substance called cementum.  The composition of cementum is a little different than enamel, as it was made to function below the gums, and not actually in the mouth like enamel.  This means just continue to practice good oral hygiene, which means brushing after each meal and flossing once a day.  Be sure not to let food or any other debris accumulate in this area.

What are the signs that the tooth is dying besides turning dark?

This varies.  Some signs can include sharp pain, increased sensitivity, a long, dull, continuous pain, sensitivity to hot, cold, or when chewing, or, as you mentioned, color change.  Also, a tooth can undergo the process of necrosis (dying) with no signs or indications.  A dentist can run several tests to determine whether the pulp is still vital.

We hope these answers helped you out.  In a situation like this, it’s pretty hard to tell exactly what’s going on without running some tests and taking a look clinically.  But hopefully these answers can guide you down the right path.  It’ll be best to go to the dentist and have an x-ray taken of the tooth and a couple of diagnostic tests performed to determine the status of the tooth.  Don’t wait too long to visit the dentist, especially if the tooth is mobile.

Hope this helps and good luck!!

Hi
The bristles on my toothbrush begin to wear away after 1 week of usage twice a day!  What should I do? Should I change my brush every week?

Answer:

This is a clear sign that you are brushing your teeth entirely too hard.  Remember, brushing, when done the right way, is great for your teeth.  However, brushing too hard is actually bad for your teeth.  It prematurely wears away enamel and can eventually cause sensitivity close to the gum line.  Enamel does not regenerate and you may eventually need a restoration (filling) if you continue to brush with great force.  Continue to brush after each meal but just remember that light to medium force is all you need to accurately clean your teeth.  The bristles in your toothbrush should at least last 2-3 months (see our article on when to change your toothbrush).  Any time less than this is an indication that you may brush too hard.  Also, if you happen to use a soft bristles, step it up to medium strength bristles.  These may last a little longer in your situation.

Good Luck!

I went to the dentist today for a routine cleaning and when the dentist came in he told the hygienist to record that I had  mottling on the upper gums in the front.  The only thing I can find about mottling involves the teeth but I am sure he said the gums.  Is this something that is bad?  If so what causes it?

Answer:

Well your research proved right in that the term “mottling”, when used in dentistry, does indeed apply to the teeth.  Mottling is used to describe the physical appearance of enamel after exposure to excess fluoride (typically in the drinking water).  The exposure usually occurs during childhood/development years and is reflected on the teeth later on.  The spots can range anywhere from paper-white patches to brown patchy discoloration.  Mottling is harmless and most individuals are only dissatisfied with the esthetic appearance.  However, if severe, other effects of excess systemic fluoride will appear such as sclerosis of the skeleton (very rare).  So if you have a white patch or brown patch on your tooth, maybe this is what your dentist was referring to.

The only term that sounds somewhat similar to mottling, which could have been used in reference to your gums, could have been stippling.  Stippling refers to a rippled appearance of the gums and is an indication of good health.

Hope this information helps you with your inquiry.  Good luck!

My tooth hurts whenever I eat hot or cold food or drinks.  If feels like a sharp pain, then it goes away.  What does this mean?

Answer:

This is a sure sign of reversible pulpitis.  The feeling that you are experiencing is caused by exposed dentin.  Remember that dentin is normally covered by enamel (see article on tooth anatomy), if for some reason a portion of dentin is left uncovered, you will usually feel sensations of short, sharp pain when exposed to hot or cold substances.  Exposed dentin can be caused by a cavity, a defective filling/restoration, or recent dental work.  The good news is that this problem can be fixed easily, the dentin just needs to be covered.  Your dentist will be able to give you a filling, simply fix your existing filling, or a pulp cap if necessary.  However, don’t wait too long.  Reversible pulpitis, if left untreated, can turn into irreversible pulpitis.  Unfortunately, irreversible pulpitis can only be treated with root canal therapy, which costs a lot more in the end.  So be sure to act now by visiting your dentist.

Good luck!

Bruxism, or grinding of the teeth, is a fairly common condition that affects a majority of the adult population (estimates range up to 85%).  It usually occurs while sleeping and the individual is completely unaware that he or she is grinding his teeth.  Unfortunately, this bad habit can lead to a host of other dental problems.

How would I know if I grind my teeth?

• Teeth appear worn down or damaged
• Enamel has been worn down exposing a yellow layer (dentin)
• Experience headaches or migraines in the morning or right after waking up
• Frequent earaches
• Ringing in the ears, especially in the morning
• Sensitive teeth
• Have a loved one observe you in your sleep, grinding of the teeth will occur quite frequently throughout the night
• Facial Pain

What causes teeth grinding [bruxism]?

Causes of bruxism are still under investigation.  However, the most common causes are as follows:

• Stress
• Anxiety
• Alcohol
• Sleep disorders
• Malocclusion

How can I treat bruxism?

Effective treatment is still in the research phase.  The best way to prevent and control grinding of the teeth is to wear a nightguard.  This can be purchased over the counter or provided by your dentist.  Also, try to find ways to reduce the amount of stress in your life.  Activities such as deep breathing and yoga have found to be successful in reducing one’s stress level.

Please do not hesitate to visit the dentist if you suspect brusixm.  Grinding of the teeth can lead to several other dental problems including TMJ issues, the need for fillings, crowns, root canals, bridges, and even extractions.  Eventually, once the grinding becomes bad, the teeth can loosen and will need to be removed.  This is definitely not an issue to take lightly.

Have more questions?  Feel free to leave a commit or submit a question to be included in our FAQ’s.

What is enamel?

Enamel is the hardest substance in the entire body.  It’s the outside layer of the tooth, completely covers the dentin, and is actually transparent in color.  That means the color of our teeth is due to dentin and not enamel.  However, enamel is comprised of enamel rods which can hold stain quite easily, including red wine, coffee, tea, and cigarettes.

What is enamel comprised of?

Enamel is comprised of 96% calcium hydroxyapatite and 4% organic material and water.  Bone is composed of 50% hydroxyapatite and 50% organic material including collagen, thus making enamel the hardest substance in the body.

If I chip or break enamel, will it repair on its own?

Unfortunatley, enamel does not contain any living cells.  Therefore, if chipped, it will not repair itself.  However, dentin can repair itself if damaged.

What is hydroxyapatite?

Hydroxyapatite is a storage form of calcium in the body.  99% of calcium in bone is stored as hydroxyapatite.  The chemical formula for hydroxyapatite is Ca₅(PO₄)₃OH.

What is dentin?

Dentin makes up the bulk of the tooth.  It completely surrounds the pulp, and is covered by enamel on the crown portion of the tooth, and by cementum on the root of the tooth.  Dentin is usually yellow in color and ultimately determines the color of the tooth, being that enamel is transparent.  Dentin is composed of dentinal tubules that communicate directly with the pulp.  This means that is bacteria reaches the dentin, usually some type of pain will be felt.  Dentin is composed of 65-70% calcium hydroxyapatite, 20-25% organic material, and 10% water.

What is cementum?

Cementum covers dentin on the root surface of the tooth.  Cementum connects the tooth to the periodontal ligaments and is therefore somewhat responsible for securing the tooth in the bone.  It is composed of 50% calcium hydroxyapatite and 50% organic material and water, the same consistency as bone.

What is pulp?

Pulp is the livelihood of the tooth.  Pulp supplies nutrients, blood, and nerves to the tooth.  This means that the pulp is responsible for keeping the dentin, cementum, and dentin strong.

Well what if my pulp is removed with a root canal?

Once bacteria reaches the pulp, depending on how extensive, it’s usually recommended to have the pulp removed.  This is because the pulp communicates directly with the rest of the body, and if harmful bacteria is present in your pulp, and it easily move to other areas of the body, including the brain!!  Please see the article on root canal for further information on this subject.