Posts for: April, 2018
Did you see the move Cast Away starring Tom Hanks? If so, you probably remember the scene where Hanks, stranded on a remote island, knocks out his own abscessed tooth — with an ice skate, no less — to stop the pain. Recently, Dear Doctor TV interviewed Gary Archer, the dental technician who created that special effect and many others.
“They wanted to have an abscess above the tooth with all sorts of gunk and pus and stuff coming out of it,” Archer explained. “I met with Tom and I took impressions [of his mouth] and we came up with this wonderful little piece. It just slipped over his own natural teeth.” The actor could flick it out with his lower tooth when the time was right during the scene. It ended up looking so real that, as Archer said, “it was not for the easily squeamish!”
That’s for sure. But neither is a real abscess, which is an infection that becomes sealed off beneath the gum line. An abscess may result from a trapped piece of food, uncontrolled periodontal (gum) disease, or even an infection deep inside a tooth that has spread to adjacent periodontal tissues. In any case, the condition can cause intense pain due to the pressure that builds up in the pus-filled sac. Prompt treatment is required to relieve the pain, keep the infection from spreading to other areas of the face (or even elsewhere in the body), and prevent tooth loss.
Treatment involves draining the abscess, which usually stops the pain immediately, and then controlling the infection and removing its cause. This may require antibiotics and any of several in-office dental procedures, including gum surgery, a root canal, or a tooth extraction. But if you do have a tooth that can’t be saved, we promise we won’t remove it with an ice skate!
The best way to prevent an abscess from forming in the first place is to practice conscientious oral hygiene. By brushing your teeth twice each day for two minutes, and flossing at least once a day, you will go a long way towards keeping harmful oral bacteria from thriving in your mouth.
If you have any questions about gum disease or abscesses, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Periodontal (Gum) Abscesses” and “Confusing Tooth Pain.”
Because the mouth is one of the most sensitive areas of the body, we go to great lengths to eliminate pain and discomfort associated with dental work. Anesthesia, both local and general, can achieve this during the actual procedure—but what about afterward while you’re recuperating?
While a few procedures may require prescription opioids or steroids to manage discomfort after a procedure, most patients need only a mild over-the-counter (OTC) pain reliever. There are several brands available from a group of medicines called non-steroidal anti-inflammatory drugs (NSAIDs). NSAIDs like aspirin or ibuprofen work by blocking the release of prostaglandins into the body, which cause inflammation in tissues that have been damaged or injured.
Unlike their stronger counterparts, NSAIDs have fewer side-effects, cost less and aren’t addictive. And unlike opioids NSAIDs don’t impair consciousness, meaning patients can usually resume normal activities more quickly.
But although they’re less dangerous than opioids or steroids, NSAIDs can cause problems if taken at too strong a dose for too long. Its major side effect is interference with the blood’s clotting mechanism, known as “thinning the blood.” If a NSAID is used over a period of weeks, this effect could trigger excessive external and internal bleeding, as well as damage the stomach lining leading to ulcers. Ibuprofen in particular can damage the kidneys over a period of time.
To minimize this risk, adults should take no more than 2400 milligrams of a NSAID daily (less for children) and only for a short period of time unless directed otherwise by a physician. For most patients, a single, 400 milligram dose of ibuprofen can safely and effectively relieve moderate to severe discomfort for about 5 hours.
Some patients should avoid taking a NSAID: pregnant women, those with a history of stomach or intestinal bleeding, or heart disease (especially if following a daily low dose aspirin regimen). If you have any of these conditions or similar concerns, be sure you discuss this with your dentist before your procedure for an alternative method for pain management.
If you would like more information on managing discomfort after dental procedures, 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 “Treating Pain with Ibuprofen.”