• Hot and/or cold sensitivity
• Pain upon biting
• Swelling in the gum tissue and/or face
• Spontaneous pain, especially if it awakens one during sleep
• A shadow at the end of the root, visible on an x-ray, which indicated bone damage from a tooth infection.

Most root canals can be performed by a general dentist in one visit. Sometimes difficult or unusual cases are referred to a specialist called an endodontist.

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Common Dental Lesions

Most lesions associated with the mouth fall into two categories: cold sores and canker sores.

Cold sores typically occur on the lips and start with a burning or itching sensation. Later an oozing sore develops. Then it will crust over and ultimately heal in 10-13 days.

Cold sores are caused by the Herpes Simplex I Virus. During the oozing stage, they are highly contageous and touching the sores should be avoided. This virus can be transferred by touch to other people or other parts of the body,especially the eyes. Once someone is infected with the virus, it remains in the facial nerves. Stress,sun exposure, trauma, or illness can cause cold sore outbreaks.

The Herpes Simplex Virus is very common and found in over 80% of the population. Although it is difficult to avoid infection, frequent hand washing and avoiding contact with infected people can help.These are treatments to help cold sores heal faster. These include Viroxyn, Zovirax, and Valtrex. These drugs do not get rid of the viruses, but they can help shorten healing time and help alleviate pain and tenderness.

Canker sores are not caused by bacteria or viruses. They are an auto immune disorder, the cause of which is unknown. Although like cold sores. stress illness and lack of sleep can help bring on outbreaks. Canker sores (Apthous Ulcers) occur inside the mouthon the cheeks, throat, underside of the tongue, and inside the lips. They do not occur on the roof of the mouth or the top of the tongue. Canker sores are not serious, but they can be quite painful. And though they will heal on their own, these are medications that will shorten healing time and decrease pain. The medications are different steroid rinses or systemic steroid (taken orally).

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Tooth Whitening

As we get older our teeth will yellow and darken. Coffee, tobacco products, tea and other pigmented foods can fasten this. But now there are simple techniques available to lighten teeth and create a more youthful appearance.

The most effective way to lighten teeth is have flexible trays made by your dentist. These trays are custom fitted and very accurate. They are not like the one size fits all trays "available at drug stores." Into these trays a gel is placed and then the trays are worn 2-3 hours. The gel is a 10%, 15% or 20% carbarnide peroxide. It has no taste and non-toxic. Typically it takes 2-4 weeks to adequately lighten teeth. Some slight, but temporary thermal sensitivity can be expected. However, bleaching or lightening does not harm the teeth. It is a very safe procedure. If sensitivity develops, there are several simple ways to lessen it.

Being advertized at some malls are instant tooth whitening. Personally, I think this technique is not safe because of the harsh chemicals and heat lamp this process requires. Also, a person should be evaluated by a dentist to see if he or she is a suitable candidate. Remember, white fillings and old crowns will not lighten.

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Cosmetic Dentistry

In todays world an attrractive smile is a very sought after thing. Just as plastic surgery has become more common, so have smile makeovers.

Sometimes, all that is needed to improve a smile is to replace old silver fillings and old white resin fillings with the new modern bonded resins available. In other cases then porcelain laminates (veneers) can be placed on the front teeth and create a perfect smile. Veneers require very little tooth removal and are very esthetic.

If the teeth are more extensively damaged from breakage or decay, crowns or "caps" may be needed. Crowns are tooth shaped coverings that can make a destroyed tooth look like new. Crooked teeth can be made straight and dark teeth white. Some cases may also involve a combination of veneers, crowns, and tooth colored fillings.

With good patient home care these cosmetic procedures are very predictable and can provide many years of a beautiful smile.

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Periodontal (Gum Disease)

The biggest cause of tooth loss in adults is periodontal disease. This used to be called pyorrhea. This disease is caused by certain bacteria which colonize around the teeth and under the gum tissue. As this disease progresses it destroys the bone around the teeth. Ultimately the teeth loosen, drift, become painful and infected, and then are lost. Very often severe pain does not occur until the disease is very advanced. Therefore, regular dental exams are needed to diagnose gum problems when they are minor and easliy treated.

Treatment may consist of just a proper teeth cleaning accompanied with oral hygiene instruction. More advanced disease may require deep scaling and root planing. This is a meticullous deep cleaning performed with local anesthetic. The most severe cases may need surgical therapy and referral to a gum specialist called a periodontist.

There are certain medicines (prescription rinses and antibiotics) which can be used in the treatment of periodontal disease. But medicines alone can't cure the problem. Meticullous home care proper treatment are vital.

The most common symptoms of gum disease are:

• Red and bleeding gums
• Persistent bad breath
• Swollen gum tissue
• Loosening teeth
• Tooth separation
• Painful gum tissue

One final note. Numerous studies have shown a direct link between periodontal disease and corornary artery disease and diabetes. So its not just the teeth we're concerned with It's your overall health. Also, periodontal disease can be passed to your spouse. So if you think you may have a gum problem, see your dentist.