The News Herald (Willoughby, OH) - - Advertising - Jef­frey Gross, DDS, FAGD is an Ohio li­censed gen­eral den­tist and is on the staff of Case Western Re­serve School of Den­tal Medicine. Jef­frey Gross, DDS, FAGD

Q: All Of My Teeth Hurt.

A: I don’t know why I was naïve. I don’t know why I al­lowed my­self to be so eas­ily duped. Well, maybe be­cause it wasn’t that long ago that I what I wished for really hap­pened. Will I ex­pe­ri­ence an­other re­peat? The an­swer is no. What is the sub­ject of this com­plaint? It is not a com­plaint. It is more of a dis­ap­point­ment. Let me tell you what I am talk­ing about. I work up last Thurs­day to find the ground all cov­ered with snow. I woke up to see that the temps were in the ‘20s. The wind was howl­ing, and it looked like a reg­u­lar Jan­uary in Cleve­land. I was se­cretly hop­ing that we would have a re­peat of the mild win­ter that we had a few years ago. It just wasn’t go­ing to oc­cur. So, what does my weather re­port have to do with my pa­tient com­plaint? It has a lot to do with teeth hurt­ing. As the weather turns very cold many of us ex­pe­ri­ence mild to se­vere pain with our teeth. Why is this so and what can be done to help in this sit­u­a­tion? To un­der­stand this phe­nom­e­non, we need a short les­son in tooth anatomy. When we first start to de­velop and grow teeth, they form from small and live en­ti­ties that we call tooth buds. These buds are filled with tis­sue that con­trols how these teeth grow. It has mapped in them to turn back teeth into large mo­lars and front teeth into square beau­ties that al­low us to flash a great smile. These lit­tle buds be­gin to de­posit and grow a hard cov­er­ing. This cov­er­ing has two com­po­nents. The first part is right next to the lit­tle bud. The sec­ond layer is around the first hard cov­er­ing and of­fers pro­tec­tion.

The hard-in­ner cov­er­ing is called dentin. The hard-outer cov­er­ing is called enamel. So once the tooth is fully formed, it has 3 lay­ers. The in­ner­most layer is filled with soft and live tis­sue. This is called the pulp. The seg­ment that sur­rounds it is called dentin and the fi­nal out­side layer is called enamel. The outer layer of enamel which is our coat of ar­mor takes on all types of as­saults. Its goal is the pro­tec­tion of what is un­der­neath. Acids, chew­ing forces, bac­te­ria all work to break down the enamel and pen­e­trate in­side. The in­side layer, the dentin, and the pulp are sen­si­tive to touch and out­side stim­uli. Cold and hot are ex­am­ples of out­side stim­uli. If we don’t have our outer layer of enamel, then hot cof­fee or cold pop or a blast of wind from off the lake will cause us to wince. If we don’t have an outer layer of enamel due to acid ero­sion from bac­te­ria, help is at­tain­able. Usu­ally, it is one or two teeth that may have this is­sue. We call this den­tal de­cay or merely a cav­ity. Mod­ern bond­ing and other tech­niques al­low us to fix the area or ar­eas quite eas­ily and quickly. If it is more se­vere than that, then more com­pre­hen­sive meth­ods such as a root canal pro­ce­dure or in the most dam­ag­ing case even re­moval of the tooth may be nec­es­sary to re­lieve the dis­com­fort. Milder cases of miss­ing enamel due to over brush­ing can also be fixed with bond­ing, but of­ten­times some sort of de­sen­si­tiz­ing medicine is all that we need. Which cat­e­gory did my pa­tient fall into? Only a thor­ough exam and care­ful lis­ten­ing on my part can an­swer this ques­tion. Most of the time it is an easy fix. So, if you are read­ing this and many of the points ring true, maybe it is time to call Me­gan and make an ap­point­ment to check it out. We all know that when we catch some­thing early, the so­lu­tions are com­fort­able, and the suc­cess rate is high. I don’t run away for the win­ter and am here to help you. Dress warmly and be care­ful out­side. For­tu­nately, spring is just about 2 months away.

The Healthy Smile 34586 Lakeshore Boule­vard (¼ mile west of Route 91 on Lakeshore Blvd) East­lake, Ohio 44095 440-951-7856 Sev­er­ance Med­i­cal Arts, Suite 603 5 Sev­er­ance Cen­ter Cleve­land Heights, Ohio 44118 216-371-2333 www.jef­frey­gross­

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