Pain anywhere in your body can be a warning of an abnormal situation. It is not always serious. For example, the pain of overeating or abdominal gas is real pain but is not dangerous and demanding urgent treatment. Teeth can also be painful due to temperature, usually cold, or pressure. Pressure can be applied either with or without food. In fact the pressure of clenching or grinding the teeth without anything in the mouth, especially while sleeping, is the most severe.

There are a large variety of dental pains and causes. A sharp pain occurring while biting something hard, which stops when the biting pressure is released, is often the sign of a cracked tooth which goes far below the surface. The crack needs to be cut out and the area filled, or the tooth crowned so no pressure can be put on the crack.

Pain from sweet, sour or cold may mean that some nerve endings are right on the surface, just like your eyeball. This area of the tooth needs to be covered and dentists have various methods to do this, depending on the circumstances. For example if the pain is coming from the area of an old filling, it often means that the seal between the filling and tooth has broken down, and fluids are leaking down the side of the filling. In this case you need to have a new filling. When the area of the tooth right at the gum line is tender to pressure, from a fingernail etc, or tooth brushing, toothpaste for sensitive teeth will often solve the problem.

When a tooth has a hole or is broken, even if it doesn’t hurt you need to see a dentist soon. If a broken tooth hurts it means that the nerve is either inflamed because of bacterial infection or irritation from being close to the surface, and exposed to various irritants that act through the thin bit of tooth structure still over the nerve. Your dentist will know the best treatment for the broken tooth.

When the pain is strong and starts with no obvious reason, you probably have an abcess. This is a pocket of puss at the end of as the root. It is the pressure of the pus building up that causes the pain. The pain goes away when the pus is no longer contained in the bone, but can flow out. The puss goes either into your mouth through a little opening which looks like a pimple. This is a draining fistula, a fistula can drain either into your mouth or nasal sinus, or just into the flesh of your face. Needless to say this needs urgent treatment.

If pain seems to appear in teeth in different parts of your mouth, it is often caused by clenching and grinding, due to stress. When you can’t control your stress, then a bruxism guard may help, or an occlusal adjustment may relieve the pain. When your dentist does an occlusal adjustment , the biting pressure is evened out on all the contacting teeth.

Pain with swelling, inside or outside your mouth, means you need to see a dentist or doctor very soon.

Gum disease occurs in varying degrees of severity. In its mildest form it is called gingivitis. The infection is on the surface of the gum tissue, and does not affect the bone, or the ligament which connects the tooth to the bone. Even though the infection is only on the surface, the gums are still red inflamed and bleed easily.

Gingivitis is caused by ineffective or insufficient tooth brushing and flossing, it is also aggravated by even a small amount of tarter at the gum line. This tarter needs to be removed and is best done in the dental office by a dental hygienist. If your gums bleed when you brush or floss, or your breath has an odour, or you have bad tasting saliva, you probably have gum disease.

When the early stages of gingivitis are left untreated, it will progress into periodontitis. At this point your gums are definitely red, swollen, tender and the bleeding and smell are worse. This is caused by tarter build up below the gum line. More important is what is going on below the gums at this point. The structures which hold your teeth attached to your jaw bones is being attacked and destroyed, by the active infection. The bone and periodontal ligament is being eaten away. You will notice some of your teeth are getting loose and tender when you eat. Again this condition needs to be treated by a dentist and hygienist. When the condition is severe with a lot of bone loss, a dental specialist is needed – the specialist is a periodontist.

Medical research has shown that the toxins that enter your blood stream as a result of gum disease may eventually lead to an early and higher incidence of heart problems. People with healthy gums generally feel better, as a whole. Good breath and a bright smile are certainly worth the effort it takes to brush and floss properly. You dentist and staff are the best place to get coaching to help you learn how.

Metal dental fillings, also known as dental amalgams, are made of approximately 50 percent silver and 50 percent mercury. You can tell if you have them in your teeth, because they are grey or almost black from corrosion. The corrosion is a natural and harmless result of the silver content.

The major reason to take into consideration when deciding whether or not to change amalgam fillings is the age of the fillings. After about 10 years in the mouth, there are signs of wear and tear. The margins or joints between the metal and tooth starts to crumble at the top where they meet. A ditch or open space develops, which collects food and bacteria and leads to decay creeping down between the tooth and filling. Eventually you have decay under the filling. About three out of four amalgams over 12 years old have this condition to some extent. Another natural tendency of amalgam is to expand over time. The microscopic expansion leads to cracks in the tooth structure appearing.

If your tooth hurts when you bite down on food, it often means that either the tooth or filling has a crack in it.

The most common material used for fillings today is composite resin. This material is tooth colored. Another major advantage of composite is that it can be bonded to the tooth – that is, “glued” to the tooth. This not only results in a very good seal between the tooth and filling, which keeps out leakage, but it also adds support to the walls of the cavity. The support strengthens the tooth which in turn reduces breaking. The opposite of amalgam, which puts expansion pressure on the tooth, leading to cracking and breakage.

If you are concerned, ask your dentist if it is time to replace your amalgam fillings because of age.

I hear this question from people who don’t like the way their front teeth look when they smile. There are many reasons for this reaction.

When front teeth have large stained fillings.
Depending on the size and shape of the fillings, and position of the front teeth, this situation can be improved by replacing the old fillings with new ones. This is of course the quickest cheapest way to improve a smile. When replacing fillings is not enough, veneers often won’t work either.

Teeth with big fillings don’t make a good foundation for supporting veneers. In this case full crowns are the best answer. They can be all porcelain or porcelain-fused to metal. There are advantages to both. Certain degrees of crookedness can be corrected with crowns.

When the problem is small yellow teeth
Dark teeth look smaller than they are, so I often suggest bleaching the top and bottom teeth. Once the teeth are bright white they appear larger and minor crookedness is not as noticeable . This again can be a fast easy solution for some people. Large and normal size yellow or grey teeth also look better once they are bleached white.

Do veneers last a lifetime?
No they don’t. Veneers are porcelain covers glued to the front teeth, after a small amount of enamel is removed to make space. Well-made veneers will last 8 to 12 years. Over the years the glue joint deteriorates and stain takes hold. Even when the joints are hidden between the teeth, the staining shows through. If you are 25 years old, how many replacements will you need by the time you are 75?

How long do crowns last?
Crowns can last 10 to 30 years depending on many factors. A lot of things happen to people and their mouths over the decades.

Over the course of my dental practice I have had many people ask me similar questions. I think by posting some of these common questions along with answers based on my experience, I can help reduce some of the stress people have about asking dental questions, never mind going to or even speaking to a dentist.

This discussion will be in everyday language, not overly technical, or judgmental.