A scoop of ice cream is one of life's little pleasures. But for one in three Americans, it could be something altogether different—an excruciating pain when cold ice cream meets teeth. This short but painful experience that can happen when dental nerves encounter hot or cold temperatures is called tooth sensitivity.

A look at tooth anatomy will help explain why. Teeth are mainly composed of outer enamel, a layer of nerves and blood vessels within the tooth called the pulp, and dentin, a porous layer in between. The pulp nerves pick up temperature and pressure sensations from outside the teeth through a network of tiny passageways (tubules) in the dentin. Enamel muffles these sensations before traveling the tubules, which prevents overstimulation of the nerves.

This careful balance can be disrupted, however, if the enamel becomes eroded by acid from foods or beverages, or as a byproduct of bacteria. This exposes the underlying dentin to the full brunt of outward sensations, which can then impact the nerves and cause them to overreact.

This hyper-sensitivity can also occur around the tooth roots, but for a different reason. Because the gums primarily protect this area rather than enamel, the roots can become hyper-sensitive if they lose gum coverage, a condition known as gum recession caused mainly by gum disease or over-aggressive hygiene.

Besides using dental products that block nerve sensation, reducing sensitivity largely depends on addressing the underlying cause. If gum disease, the focus is on removing plaque, a bacterial film on dental surfaces that causes and sustains the disease. Stopping an infection allows the gums to heal and hopefully regain their original teeth coverage. More advanced cases, though, may require grafting surgery to foster gum regeneration.

If the cause is enamel erosion or other results of decay or trauma, we can utilize a number of treatments depending on the extent of tooth damage including cavity filling, root canal therapy or crowning. As a last resort, we may need to remove a tooth that's beyond reasonable repair.

If you've begun to experience sensitive teeth, it's important that you see us as soon as possible. The earlier we can diagnose the cause, the less invasive we can be with treatments to ease or even stop this most unpleasant experience.

If you would like more information on tooth sensitivity, 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 “Treatment of Tooth Sensitivity.”

Fluoride is an important part of your child's dental development. But if children take in too much of this important mineral, they could experience enamel fluorosis, a condition in which teeth become discolored with dark streaking or mottling.

That's why it's important to keep fluoride levels within safe bounds, especially for children under the age of 9. To do that, here's a look at the most common sources for fluoride your child may take in and how you can moderate them.

Toothpaste. Fluoridated toothpaste is an effective way for your child to receive the benefits of fluoride. But to make sure they're not getting too much, apply only a smear of toothpaste to the brush for infants. When they get a little older you can increase that to a pea-sized amount on the end of the brush. You should also train your child not to swallow toothpaste.

Drinking water. Most water systems add tiny amounts of fluoride to drinking water. To find out how much your water provider adds visit “My Water's Fluoride” (//nccd.cdc.gov/doh_mwf/Default/Default.aspx) online. If it's more than the government's recommendation of 0.70 parts of fluoride per million parts of water, you may want ask your dentist if you should limit your child's consumption of fluoridated drinking water.

Infant formula. Many parents choose bottle-feeding their baby with infant formula rather than breastfeed. If you use the powdered form and mix it with tap water that's fluoridated, your baby could be ingesting more of the mineral. If breastfeeding isn't an option, try using the premixed formula, which normally contains lower levels of fluoride. If you use powdered formula, mix it with bottled water labeled “de-ionized,” “purified,” “demineralized” or “distilled.”

It might seem like the better strategy for preventing fluorosis is to avoid fluoride altogether. But that can increase the risk of tooth decay, a far more destructive outcome for your child's teeth than the appearance problems caused by fluorosis. The better way is to consult with your dentist on keeping your child's intake within recognized limits to safely receive fluoride's benefits of stronger, healthier teeth.

If you would like more information on fluoride and your baby's dental health, 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 “Tooth Development and Infant Formula.”

A wave of madness is about to sweep across Indianapolis and onto television screens across America—March Madness, that is. That's right: After its cancellation in 2020 due to COVID-19, the famed NCAA men's basketball tournament is back with all 68 games scheduled to be played in and around Indianapolis. As you can imagine, there will be numerous health precautions, and not just for the pandemic—there should also be mouthguards aplenty.

Why mouthguards? Although you might think football and hockey would be rougher on players' teeth, gums and jaws, basketball actually tops the list of sports with the most dental injuries. Such an injury occurring from a split-second contact with another player could take years to overcome.

Fortunately, mouthguards are a proven way to reduce sports-related mouth injuries among professional and amateur basketball athletes. Made of a pliable plastic, mouthguards cushion against blunt forces to the mouth generated during play (and not only formal games—practices and scrimmages too).

But while wearing a mouthguard is a no-brainer, choosing one can be a little intimidating. True, they all work on the same principle, but there are dozens of types, designs and price ranges.

We can, however, distill them down to two basic categories: “boil and bite” and custom mouthguards. You'll find the first kind online or in a local retail sporting goods store. It's named so because you first place it in hot water to soften it, and then place it in the mouth and bite down to create an individual fit.

As an inexpensive option, boil and bite mouthguards provide a level of protection. But they also tend to be bulky and uncomfortable, which can tempt players to wear them less. And the softer plastic (compared to custom guards) allows for a lot of jaw (and in turn, teeth) movement, which can cause teeth to loosen over time.

Custom mouthguards, on the other hand, are created by dentists based on impressions made of the wearer's mouth. As such, the fit tends to be more precise, requiring less material than the boil and bite variety, thus affording a greater degree of comfort. And there's less potentially damaging jaw movement with a custom mouthguard. As you might imagine, custom mouthguards are more expensive, but compared to the potential treatment cost for a sports-related dental injury, it's money well spent.

Investing in a custom mouthguard for your family basketball (or football, hockey or baseball) player is a sound way to protect their dental health. And that's not madness at all.

If you would like more information about athletic mouthguards, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Athletic Mouthguards.”

Chronic joint pain (temporomandibular joint disorder or TMD) in and of itself can make life miserable. But TMD may not be the only debilitating condition you're contending with—it's quite common for TMD patients to also suffer from fibromyalgia.

Fibromyalgia is a condition with a variety of muscular and neurological symptoms like widespread pain, joint stiffness, headaches and tingling sensations. These symptoms can also give rise to sleep and mood disorder, as well as difficulties with memory. Fibromyalgia can occur in both males and females, but like TMD, it's predominant among women, particularly those in their child-bearing years.

In the past, physicians were mystified by these symptoms of body-wide pain that didn't seem to have an apparent cause such as localized nerve damage. But continuing research has produced a workable theory—that fibromyalgia is related to some defect within the brain or spinal cord (the central nervous system), perhaps even on the genetic level.

This has also led researchers to consider that a simultaneous occurrence of TMD and fibromyalgia may not be coincidental—that the same defect causing fibromyalgia may also be responsible for TMD. If this is true, then the development of new treatments based on this understanding could benefit both conditions.

For example, it's been suggested that drugs which relieve neurotransmitter imbalances in the brain may be effective in relieving fibromyalgia pain. If so, they might also have a similar effect on TMD symptoms.

As the study of conditions like fibromyalgia and TMD continues, researchers are hopeful new therapies will arise that benefit treatment for both. In the meantime, there are effective ways to cope with the symptoms of TMD, among them cold and hot therapy for inflamed jaw joints, physical exercises and stress reduction techniques.

The key is to experiment with these and other proven therapies to find the right combination for an individual patient to find noticeable relief. And perhaps one day in the not too distant future, even better treatments may arise.

If you would like more information on the connection between TMD and other chronic pain conditions, 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 “Fibromyalgia and Temporomandibular Disorders.”

What a difference forty years can make: Dental bridges once occupied the top spot for choices to replace missing teeth until the arrival of dental implants in the 1980s. Today, dental implants are the gold standard for dental restoration.

But although bridgework may have lost “first chair” in the orchestra of restorations, it's still a viable option. In fact, it can be the best option in certain situations.

Bridges consist of a series of porcelain crowns fused together like fence pickets. The center crowns, known as the pontics, “bridge” the gap left by a missing tooth or teeth. The crowns on each end, the abutment teeth, crown the natural teeth on either side of the gap to support the bridge.

Bridges are effective and durable, but with a major downside: To accommodate the abutment crowns, we must reduce the size of the natural teeth to which they'll be attached. This alteration can weaken those teeth's structure and require them from then on to have some form of restoration. They're also at higher risk for tooth decay.

Implants, on the other hand, don't require this alteration, and may also be more durable than bridges. Why then consider a bridge?

Price can be a factor: Implants may be more expensive, especially involving multiple teeth. Keep in mind, though, that this only compares the initial cost: Because implants have a 95% or more ten-year success rate, with further evidence they could potentially last for decades, they may actually cost less in the long-run than bridge restorations that have a higher chance of being replaced sooner.

But the prime reason is that some dental situations aren't suitable for dental implants. For instance, implants require a certain amount of bone for proper placement, so people with extensive bone loss may not be able to acquire them. Health conditions like uncontrolled diabetes or a compromised immune system can also complicate implant installation. A bridge in these cases may represent a better alternative.

With the help of your dentist, you'll need to consider your individual situation, dental and financial, in deciding between an implant or a bridge. And, if a dental bridge is your best option, it will be a solid choice for restoring your missing teeth and your smile.

If you would like more information on various dental restoration methods, 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 “Crowns & Bridgework.”