If you engage in frequent air travel, you have probably experienced pain in your ears and sinuses related to pressure changes. The pain is caused by “barotraumas” (from baro meaning pressure — also the root of the word “barometer” — and trauma meaning injury) and is also called a “squeeze.” Divers also sometimes experience this discomfort or pain.

The cause of barotraumas is air pressure (or water pressure, in the case of divers) on the outside of your body that is not equal to the pressure inside your body. Normally when pressure outside your body changes, your organs such as your blood, bones, and muscles transmit the changes equally from outside to inside. Some structures in your body, such as your middle ear spaces and your sinus cavities (spaces in the facial bones of the skull), don't transmit the pressure as well because they are filled with air and have rigid walls. The maxillary (upper jaw) sinuses are pyramid-shaped spaces in the bone located below your eyes, on either side of your nose.

You have probably tried to stop such pain in your ears by yawning, chewing, or moving your jaw back and forth. These maneuvers, called “clearing,” allow air to move from the back of your throat into your ear canals so that the pressure can equalize. Similarly, your sinuses have small openings near their lower borders, so that you can clear pressure changes within them. If you have a head cold or flu and the membranes lining your sinuses are swollen and inflamed, they may close off the openings and make it difficult to clear these spaces. This can sometimes lead to intense pain.

Because the lower walls of these sinuses are adjacent to your upper back teeth, these teeth share the same nerves as the maxillary sinuses. This sharing sometimes causes pain felt in your back teeth to be perceived as pain in the sinuses, or vice versa. Pain felt a distance from its actual stimulus because of shared nerves is called “referred pain.”

Be sure to make an appointment with us if you experience pain in any of your teeth. Any defect in a filling or tooth can allow air to enter the tooth. It could be referred pain from your sinuses, or the result of pressure changes on trapped air within a filling or a tooth. Such pain, called barodontalgia (from baro meaning pressure, don't meaning tooth, and algia meaning pain) is an early sign of injury in a tooth.

Contact us today to schedule an appointment to discuss your questions about tooth and sinus pain. You can also learn more by reading the Dear Doctor magazine article “Pressure Changes Can Cause Tooth & Sinus Pain.”

Your teeth were designed to last you a lifetime, so you should do everything you can to protect them. This includes guarding them against dental erosion. However, many people may not know for sure what dental erosion is, much less how or why they need to guard against it.

Dental or tooth erosion is the irreversible loss of tooth enamel from chemical attack by acids. Eating or sucking acidic foods such as lemons is a good example. But most people are shocked to discover that it can also be caused by their favorite sodas (carbonated beverages), natural fruit juices, energy and sports drinks — especially with excessive consumption. It takes the saliva, nature's protection, at least 30 to 60 minutes to neutralize the effects of acid, so only one acidic drink an hour causes your teeth to be continually bathed in acid. And this is an important fact to know, because if your mouth is acidic all the time, this will promote tooth decay.

Will brushing help out with prevention?

When it comes to dental erosion, brushing immediately after acid consumption can actually make it worse by accelerating the erosion process. This is because the acids in these drinks (and some foods) actually dissolves tooth enamel and softens the tooth surface. These newly softened surfaces can literally be brushed away if you brush before your saliva has a chance to try to reverse the process. If done often, you could even brush away your enamel! For this reason, you should wait at least 30 to 60 minutes before you brush your teeth after consuming any of these products.

So what can you do to prevent dental erosion?

One important step that you (and your family) can do to help prevent dental erosion is to limit the amount of these beverages you drink. Instead, try drinking calcium-rich milk or water and saving your favorite acidic beverage for a special treat that you consume preferably with a meal. Try reducing the number of these drinks you consume over a period of time. If you must drink an acidic beverage avoid swishing it in the mouth and use a straw to reduce the contact between the acid and your teeth.

Just remember that once your dental enamel has eroded, it is gone forever. So you should follow these simple tips now to protect your smile and future.

If you wake yourself by snoring or have been told by others that you snore, you should share this fact with us during your next visit. Why? Many people are shocked to learn that their dentist is a vital resource for treating snoring and Obstructive Sleep Apnea (OSA), a condition that occurs when the upper airway (back of your throat) is blocked or obstructed causing significant airflow disruption or even no airflow whatsoever for 10 seconds or more.

Self Test For Sleep Apnea

While your responses to the following questions are not a diagnosis for OSA, they can be warning signs that you may have OSA or another condition that is impacting your sleep.

1. Are you a loud habitual snorer?
2. Has anyone ever witnessed you holding your breath, gasping for air or even choking while asleep?
3. Do you regularly feel un-refreshed or tired even after waking from eight or more hours of sleep?
4. Do you find yourself easily falling asleep throughout your day at work or at home?
5. Do you suffer from poor concentration or judgment, memory loss, irritability and/or depression from lack of sleep?
6. Are you 15 pounds over the normal weight range for your height and/or does you neck measure more than 17 inches around if you are male and 16 inches if you are female?

If you answered, “yes” to any of the above questions, you should share your responses to all of these questions with both your physician and us so that you can receive a thorough examination to address your sleep concerns. And if you are diagnosed with OSA, we can help with specific oral treatment options that may work best for you.

Learn More

Learn more about the signs, symptoms, and treatment options when you read “Snoring & Sleep Apnea.” Contact us today to discuss your questions or to schedule a consultation.

We say that we are going to have our teeth cleaned — but a lot more than simple cleaning takes place during a visit to a dental hygienist.

1. Health History
   Your hygienist will ask you about your general health and your dental health and any recent changes in either. By doing so she will pinpoint any issues that require special precautions during your cleaning.
2. Cancer Screening
   Next, the hygienist carefully examines the skin in and around your mouth looking for lumps, bumps, sores, tenderness or swellings and refers areas of concern to the dentist for further evaluation. The hygienist is one of the few people who get to closely assess your whole mouth, so she is trained to spot cancer and other diseases.
3. Evaluating Your Periodontal Health
   Your hygienist will look closely at the state of your periodontal health (from peri meaning around and dont meaning tooth). This includes checking your gums and the other tissues surrounding your teeth for inflammation (gingivitis) or bleeding.
4. Checking for Decay
   The hygienist will examine your teeth for decay and will note the location and condition of stains or hard mineral deposits (calculus or tartar). These deposits result from a buildup of plaque (a film of bacteria) that has not been removed by daily brushing.
5. Scaling
   The hygienist uses hand tools or a sonic scaler to remove the calculus from your teeth.
6. Polishing
   A mechanical polisher and an abrasive polishing compound are used to polish the surface of your teeth so that they are smooth, making them more resistant to plaque, removing stains and leaving your teeth feeling squeaky clean.
7. Measuring
   The hygienist uses a tiny probe to measure the space between your teeth and gums. Periodontal disease begins by forming pockets between the teeth and gums, so this measuring is key to your periodontal health. Generally a space of 3mm or less indicates healthy gums, pockets of 4 to 5mm indicate periodontal disease that may be reversed with good oral care at home, and pockets that are 6mm deep or more require specialized treatment by a dentist or periodontist (a dentist who specializes in care of gums).
8. Education
   Based on the observed conditions of your gums and teeth, the hygienist will provide information aimed at improving your home oral cleansing routines and about your risk for tooth decay and gum disease.
9. Making Your Next Appointment
   The hygienist will make an appointment for your next cleaning — in three, four, or six months depending on the health of your gums and teeth. Keeping these appointments not only keeps your teeth looking their best, but it also assures good management of your dental health.

Contact us today to schedule an appointment to discuss your questions about dental hygiene. You can also learn more by reading the Dear Doctor magazine article “Dental Hygiene Visit.”

We tend to think of aspirin as a harmless medication. It is dispensed over the counter and is the most widely used OTC medication in the U.S. We take it without thinking we may be exposing ourselves to risks. But in certain situations aspirin can cause dangerous side effects.

What is aspirin, and how does it work?
The chemical name for aspirin is acetylsalicylic acid. It is used to reduce mild pain, inflammation and fever. When you take an aspirin, it blocks the formation of prostaglandins, substances your body creates that are associated with inflammation. Prostaglandins cause inflamed tissues to become red and swollen, but they also serve protective purposes, such as forming a barrier that protects the stomach from the acid it produces to digest your food. That's why long-term aspirin use can sometimes cause stomach bleeding and ulceration or other health problems.

Why do cardiac patients take aspirin?
Another effect of aspirin is to prevent blood platelets from clumping together. Blood platelets are structures in the blood, smaller than white or red blood cells, that aid clotting by sticking together at the site of an injury. This effect of aspirin can cause prolonged bleeding, but it may be beneficial to people who have cardiovascular (from cardio, meaning heart; and vascular, meaning vessel) disease with narrowed blood vessels.

Aspirin can keep blood flowing in the obstructed vessels and thus prevent heart attacks and strokes; but it can also increase the risk for strokes that are caused by bleeding in the brain. Most physicians attempt to lower such risks by asking their patients to keep their daily aspirin consumption to a low dose 81 mg “baby” aspirin.

How does aspirin affect your teeth and gums?
Be sure to let your medical and dental professionals know you are taking aspirin, and how much you take. Also tell us about other OTC medications you take, including herbal medications and supplements, because they may interact with aspirin to cause side effects.

If you have been told to take aspirin because of a cardiac condition or procedure, be sure to follow your recommended treatment. Do not suddenly discontinue aspirin therapy; doing so can increase your risk for heart attack and stroke. Ask us if you should stop taking aspirin before a major dental or oral surgery, but do not stop taking it on your own. We will consult with your physician about your medical condition and let you know our recommendation. In most cases you can continue your aspirin therapy without causing excessive bleeding during the dental procedure.

Contact us today to schedule an appointment. You can also learn more by reading the Dear Doctor magazine article “Aspirin: Friend or Foe?”