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OROFACIAL PAIN

Detailed description: Trigeminal neuralgia (TN) is a chronic pain disorder that affects the trigeminal nerve, which is the fifth cranial nerve. The trigeminal nerve is responsible for sensation in the face, including the forehead, cheeks, jaw, and teeth. TN is characterized by sudden, sharp, electric-like pains on one side of the face. The pain can be triggered by everyday activities, such as chewing, brushing teeth, or even touching the face. Radiofrequency ablation (RFA) is a minimally invasive procedure that can be used to treat TN. RFA uses heat to destroy a small portion of the trigeminal nerve, which prevents it from sending pain signals to the brain. RFA is a safe and effective procedure that can provide long-term pain relief for people with TN.
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Radiofrequency Treatment for trigeminal Neuralgia and facial pains

Radiofrequency treatment for Trigeminal Neuralgia

Trigeminal Neuralgia: Minimally invasive treatment option

Trigeminal Neuralgia

Radiofrequency Ablation for Trigeminal Neuralgia

Trigeminal neuralgia is a condition that causes painful sensations similar to an electric shock on one side of the face. This chronic pain condition affects the trigeminal nerve, which carries sensation from your face to your brain. If you have trigeminal neuralgia, even mild stimulation of your face — such as from brushing your teeth or putting on makeup — may trigger a jolt of excruciating pain.
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Know everything about Trigeminal Neuralgia and its treatment options.

There are a few commonly seen trigger points, which when stimulated start the attack. These trigger points could be: • Upper lip, Ala of the nose • Forehead just above the eye, just below the lower eyelid. • Just in front of the ear, Upper or lower gum Touching one or more of these points, blast of cold, even a gentle breeze against the face, brushing teeth (the toothbrush touching the gums), washing face, shaving, jaw movements while talking or chewing etc bring on the attack.

In the initial phase, the attacks are short and there is a long gap between them. Progressively the attacks tend to become longer, more severe and more frequent. There may be sudden disappearance of the attacks for a few days or months, but gradually these attack ‘Holidays’ also become rare and then disappear. In patients who are not treated in time, the attacks become almost continuous and the sufferer is reduced to a miserable person, begging for relief.

The diagnosis of TN is made on the basis of a good medical history. Usually, the description of pain and the patient’s severe agony while talking, typical facial contouring and defensive facial posturing to avoid an attack immediately give away the diagnosis. A good quality MRI with Trigeminal nerve sequences is the next step, primarily to rule out tumours. An MRI-demonstrable vessel compressing the nerve is helpful, but is not a pre-requisite for surgical decision. This is because, severe vascular compression does exist, demonstrable at surgery even when MRI does not show it.

In the initial phase of the disease, some medicines like Carbamazepine (Tegretol) and Gabapentin are useful. However, they are nerve-numbing medicines and act only for a short time. They do not treat the root-cause of the disease. At our Trigeminal neuralgia centre, we have been relieving these patients of pain, with a surgery known as Microvascular Decompression (MVD). This surgery is performed with a neurosurgical microscope, and if done in time and by an experienced team it gives excellent results in more than 95% of the patients. MVD surgery has a great potential to give a long-term relief from pain and may permanently cure the patients. More importantly, the patient can stop their brain-numbing anti-epileptic medicines.

Pain is very severe and it comes as electric shock like pain. It is felt on one side of face. Pain is triggered by even touch. It comes for few seconds to few minutes. The pain is so distressing that sometimes it is also called “suicidal pain”

Management starts with medications to suppress the abnormal pain signals. The medicines used are in class of anti convulsant and anti depressants, as these medicines also have role in pain medicine. If medical management fails that means, if there is not much relief or the doses are causing some side effects, the pain specialist or the pain doctor may advise you for some minimally invasive brain procedure to block the pain signals.

Use soft tooth brush and avoid irritating tooth pastes containing mint and salt. At times it is not possible to even shave. You may use anti septic mouth wash if u are not able to brush your teeth.

Most of the patients respond to medical management by pain specialists. Pain doctors will start titrating the doses of medicine till you have significant relief. At times, they may add another class of medicine. The dose adjustment usually takes 4-6 weeks. It may even take longer. When medical management fails, minimally invasive pain procedures like Radiofrequency ablation of trigeminal nerve is the best and the safest technique, if surgery is not indicated.

Radiofrequency ablation or RFA blocks the pain signals from reaching brain. You may feel slight numbness in the area of pain after the procedure but that usually doesn’t affect your activities. RFA takes 2-4 weeks for its affect and during this time your pain specialist will start tapering the doses of medications. The pain may come back after 6 months to one and half year and the same procedure can be repeated. Surgical microvascular decompression MVD , is considered when the blood vessels is compressing the trigeminal nerve or Trigeminal Root.

Most often trigeminal neuralgia is confused with dental pain. At times dental infection leads to swelling over face and pain is felt on the cheeks too. Your pain specialist, will be able to detect the exact cause of pain. Many times patient undergo multiple tooth extraction without any relief.

Pain specialist are trained in diagnosing acute and chronic pain states. This is especially important, because if the diagnosis is not established, it is difficult to treat conditions and at times lead to unnecessary treatments too. Pain doctors not only manage pain with medications but they also are experts in minimally invasive procedures for pain management.

Face pain is also caused by tooth aches, herpes infection, parotic gland inflammation or infection, migraine, sinusitis.

TOOTHACHE

A toothache, which is any pain or soreness in or around a tooth, can be a frustrating and unpleasant experience. In addition to feeling a sharp or dull pain, your tooth may be sensitive to temperature. You may also experience pain when chewing or biting.
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TOOTHACHE

TOOTHACHE

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• Tooth decay • Abscessed tooth • Tooth fracture • A damaged filling • Repetitive motions, such as chewing gum or grinding teeth • Infected gums

• Tooth pain that may be sharp, throbbing, or constant. In some people, pain results only when pressure is applied to the tooth. • Swelling around the tooth • Fever or headache • Foul-tasting drainage from the infected tooth

Various dental procedures may be needed to treat certain conditions. • For tooth decay and cavities, the primary treatment is removal of the decay by drilling. The removed area is then restored with a strong material, known as a filling. • For irreversible pulpitis, your dentist may perform a root canal, where the infected pulp of the tooth is removed. • For an abscess, your doctor may make a small cut and drain the infected pocket. • Depending on the extent of the damage, a cracked tooth may need a filling, a root canal, or to be removed and replaced.

To prevent cavities, gum disease, and tooth sensitivity, try to practice good oral hygiene by: • Brushing your teeth gently twice a day and using a toothpaste with fluoride • Flossing daily • Drinking fluoridated water • Getting regular professional dental cleanings • Not smoking • Avoiding habits like biting down on pencils or forks

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TMJ disorders

TMJ disorders

TMJ disorders

Temporomandibular disorders (TMD) are disorders of the jaw muscles, temporomandibular joints, and the nerves associated with chronic facial pain. Any problem that prevents the complex system of muscles, bones, and joints from working together in harmony may result in temporomandibular disorder. The National Institute of Dental and Craniofacial Research classifies TMD by the following: • Myofascial pain. This is the most common form of TMD. It results in discomfort or pain in the fascia (connective tissue covering the muscles) and muscles that control jaw, neck and shoulder function. • Internal derangement of the joint. This means a dislocated jaw or displaced disk, (cushion of cartilage between the head of the jaw bone and the skull), or injury to the condyle (the rounded end of the jaw bone that articulates with the temporal skull bone). • Degenerative joint disease. This includes osteoarthritis or rheumatoid arthritis in the jaw joint.
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The temporomandibular joints (TMJ) are the 2 joints that connect your lower jaw to your skull. More specifically, they are the joints that slide and rotate in front of each ear, and consist of the mandible (the lower jaw) and the temporal bone (the side and base of the skull). The TMJs are among the most complex joints in the body. These joints, along with several muscles, allow the mandible to move up and down, side to side, and forward and back.

In many cases, the actual cause of this disorder may not be clear. Sometimes the main cause is excessive strain on the jaw joints and the muscle group that controls chewing, swallowing, and speech. This strain may be a result of bruxism. Arthritis and displacement of the jaw joint disks can also cause TMD pain. In other cases, another painful medical condition such as fibromyalgia or irritable bowel syndrome may overlap with or worsen the pain of TMD.

Signs and symptoms of TMJ disorders may include: • Pain or tenderness of your jaw • Pain in one or both of the temporomandibular joints • Aching pain in and around your ear • Difficulty chewing or pain while chewing • Aching facial pain • Locking of the joint, making it difficult to open or close your mouth

• Various types of arthritis, such as rheumatoid arthritis and osteoarthritis • Jaw injury • Long-term (chronic) grinding or clenching of teeth • Certain connective tissue diseases that cause problems that may affect the temporomandibular joint

Treatment may include: • Resting the temporomandibular joint (TMJ) • Medicine or pain relievers • Relaxation techniques and stress management • Behavior changes (to reduce or stop teeth clenching) • Physical therapy • An orthopedic appliance or mouthguard worn in the mouth (to reduce teeth grinding) • Posture training • Diet changes (to rest the jaw muscles) • Ice and hot packs • Surgery

Root canal treatment

Root canal treatment is a dental procedure which is done in severely infected tooth or tooth with abscess. In this treatment inflamed part of the tooth is removed. Inside of the canal is then cleaned and shaped and filling is done to seal the space.
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Root canal treatment

Root canal treatment

Root canal treatment

FAQS

• Severe pain • Abscess on gums • Fractured tooth • Deep caries • Discoloration of tooth

In root canal treatment infected tissues of the pulp are removed and thorough cleaning of the canals is done and canals are disinfected, then the canals are filled.

While doing the root canal procedure, proper anaesthetic agent is given to avoid pain during the treatment. In the initial appointment, there might be sensitivity because of the inflammation of the pulp tissue.

You should not chew or bite on the treated tooth till you get a crown or prosthesis done for that tooth. Unrestored tooth are more susceptible to fracture. You have to maintain oral hygiene with regular brushing and flossing.

It is always better to save the tooth whenever it is possible because it will maintain integrity of the mouth. Extraction of the tooth is a complex procedure and it may also affect gums and neighbouring teeth.

If the tooth is left untreated, the infection of the tooth can spread to other part of the body and sometimes can even be life threatening.

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Professional Teeth Whitening

Professional Teeth Whitening

Your smile is one of the first thing people notice about you. Having white teeth will not only make you took beautiful but also confidential. When stained or yellow teeth make you hide your smile, it is time to act. Professional teeth whitening procedures has become one of the most requested treatment today. Here are answers to some of your questions which will help brighten your smile.
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There are various methods such as whitening gels, trays, toothpaste but they are less effective. Chair side teeth whitening method is most effective. In this method dental professional will clean and polish the teeth and then apply the whitening gel over the teeth. Depending upon the whitening gel used, special light is used to increase the whitening effect.

Some patients experience temporary sensitivity after teeth whitening and some may not experience at all. But the sensitivity lasts only for 48 hours. You can ease discomfort caused by sensitivity by using special toothpastes.

Professional whitening can whiten your teeth in less than an hour.some patients with deep stains may require multiple visits to get a desired teeth shade.

Various studies prove that professional teeth whitening does not harm the enamel of your teeth because in this safe percentage of bleaching agent is used which will not harm your teeth or gums.

How long your teeth will stay white depends upon your lifestyle and habit. People who eat and drink stain causing food in large amount may notice their teeth changing colour little earlier. Having regular dental cleanings will help you keep teeth white as long as possible.

DENTAL IMPLANTS

A dental implant is a structure that replaces a missing tooth. With screw-like devices, the surgeon inserts an implant into the jawbone, and it acts as an anchor for an artificial tooth, called a crown. A device called an abutment connects the artificial tooth to the dental implant. The crown is custom-made to fit the person’s mouth and match the colour of their teeth. Crowns look, feel, and function like natural teeth.
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DENTAL IMPLANTS

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DENTAL IMPLANTS

There are many advantages to dental implants, including: • Improved appearance. Dental implants look and feel like your own teeth. And because they are designed to fuse with bone, they become permanent. • Improved speech. With poor-fitting dentures, the teeth can slip within the mouth causing you to mumble or slur your words. Dental implants allow you to speak without the worry that teeth might slip. • Improved comfort. Because they become part of you, implants eliminate the discomfort of removable dentures. • Easier eating. Sliding dentures can make chewing difficult. Dental implants function like your own teeth, allowing you to eat your favourite foods with confidence and without pain. • Improved self-esteem. Dental implants can give you back your smile and help you feel better about yourself. • Improved oral health. Dental implants don't require reducing other teeth, as a tooth-supported bridge does. Because nearby teeth are not altered to support the implant, more of your own teeth are left intact, improving long-term oral health. Individual implants also allow easier access between teeth, improving oral hygiene. • Durability. Implants are very durable and will last many years. With good care, many implants last a lifetime. • Convenience. Removable dentures are just that; removable. Dental implants eliminate the embarrassing inconvenience of removing dentures, as well as the need for messy adhesives to keep them in place.

Dental implants require the same care as real teeth, including brushing, flossing, rinsing with an antibacterial mouthwash, and regular dental check-ups.

There are two types of dental implant: endosteal and subperiosteal. Endosteal implants are the most common type. A surgeon embeds them in the jawbone, and each can hold one or more artificial teeth. A surgeon affixes a subperiosteal implant on top of the jawbone. Dental surgeons choose this option for people who do not have much height to their jawbone.

What Is Involved in Getting a Dental Implant? The first step in the dental implant process is the development of an individualized treatment plan. The plan addresses your specific needs and is prepared by a team of professionals. This team approach provides coordinated care based on the implant option that is best for you. Next, the tooth root implant, which is a small post made of titanium, is placed into the bone socket of the missing tooth. As the jawbone heals, it grows around the implanted metal post, anchoring it securely in the jaw. The healing process can take from six to 12 weeks. Once the implant has bonded to the jawbone, a small connector post -- called an abutment -- is attached to the post to securely hold the new tooth. To make the new tooth or teeth, your dentist makes impressions of your teeth. A replacement tooth, called a crown, is then attached to the abutment.