Paul Falvey DDS, MS, FAAID, AFICOI

You feel it coming on: A spot in your mouth starts to burn or tingle, and you know what’s about to happen. By tomorrow you’ll have a nagging sore cratered into the lining of your cheek. Aphthous ulcers afflict 20% of the population, recurring intermittently and often without a distinct pattern. After a week or two, the pain disappears and your mouth feels whole again.

Aphthous ulcers are sometimes confused with cold sores, but they’re only related by their discomfort and proximity to each other.  Cold sores occur on the lips and surrounding skin as a result of the Herpes Simplex Virus.  Aphthous ulcers don’t have such a clear cause.  These lesions show up on movable tissue surfaces inside the mouth and may be difficult to pin to a single instigator.  We understand that the body’s immune system sends inflammatory cells into an area and destroys its own tissue, but what triggers the assault?

Where Do They Come From?

Mouth sores may show up one at a time or in groups spread across multiple areas.  Many patients feel frustrated by their inability to control these painful ulcers, but understanding possible causes may help you take steps to eliminate or reduce outbreaks.  Here are a few triggers to consider:

• Stress | If we started a list of all the maladies stress creates in our bodies, we’d need to buy a ream of paper to finish it.  Aphthous ulcers often erupt when we’re experiencing a high level of stress.
• Hormone Changes | Some women experience outbreaks before their period, while others are ulcer-free until after menopause.
• Vitamin and Mineral Deficiencies | Low levels of iron, vitamin B12, calcium, selenium, or folic acid are just a few nutrients linked to aphthous ulcers.
• Genetics | A lot of health conditions run in the genes, and mouth ulcers seem to be one to add to the list.
• Toothpaste | Most toothpastes contain a foaming agent called sodium lauryl sulfate (SLS). This ingredient is linked to mouth ulcers in some patients.  Sensitivity to mint flavoring may also lead to a similar problem.
• Systemic Diseases | Crohn’s Disease, Coeliac Disease, Reactive Arthritis, and Behcet’s Disease are a few conditions that might also include mouth sores.
• Medications | Some people find that non-steroidal anti-inflammatory drugs, like ibuprofen, lead to mouth sores.  Beta-blockers, used to treat high blood pressure and certain heart conditions, along with chemotherapy agents, are also culprits.
• Foods | When a sore shows up, consider certain foods in your diet in the previous 24 hours. Chocolate, coffee, spicy foods, peanuts, almonds, strawberries, cheese, and wheat flour are known initiators.

Most episodes of aphthous ulcers clear up and move on within a couple of weeks.  If you have a sore that doesn’t resolve within a month, it’s time to see the team at Paul I. Falvey, DDS . In these cases, a closer analysis of the area should be done.

While identifying a cause may lead to a lifestyle adjustment that eliminates sores, many patients end up enduring the discomfort until they heal. Here are a few tips to minimize the disruption:

• Be Gentle | Stay away from spicy or acidic foods during an outbreak. Use a soft toothbrush and consider an SLS-free toothpaste for awhile.
• Numb It | Grab a tube of a numbing or coating agent like Oragel, Kanka, or zilactin-B. Carry it in your pocket and apply as needed to cut the pain.
• Rinse | You might try mixing ¼ cup hydrogen peroxide, ¼ cup water, 1 tsp baking soda, and 1 tsp salt to create a rinse that disinfects and neutralizes sore spots. This mix is particularly useful if you’re suffering from multiple ulcers. Rincinol PRN is a commercial rinse available at many retailers that draws strong reviews from users.
• Try Tea | Some patients get relief by applying a damp tea bag to a mouth sore for a few minutes at a time. You may also find that sipping licorice tea helps.
• Bump B-12 | A well-designed research project showed that patients taking 1000 mg of sublingual B-12 experienced a significant reduction in mouth ulcers and pain levels. Regardless of initial B12 blood levels, 74% of patients were ulcer-free after six months compared to 32% in the control group.  Definitely worth considering!
• Chat With Us | If you’re dealing with mouth ulcers, talk to us the next time you’re in our office. We may be able to personalize our recommendations and offer other management suggestions.

At Paul Falvey, DDS, we want to help you find answers to every question you have about your dental health. Aphthous ulcers frustrate many people, but sometimes just one tip contributes to reducing your pain. We look forward to discussing all your concerns at your next visit!

Even if you don’t suffer from headaches, you’ve probably experienced “brain freeze” after a scoop of your favorite ice cream.  While experts don’t really know why it happens, it’s believed that the cold against your warm palate causes blood vessels to constrict and relax suddenly. This vessel spasm results in a burst of pain, leaving you empathetic to the 28 million Americans that suffer from migraines. Add another 20 million who deal with chronic headaches of other origins and you understand why doctors hear about this ailment often. In fact, physicians report headaches as the number one medical complaint and frequently order a variety of tests in search of a cause.

Headaches rarely indicate the presence of a serious disease. But if you’re dealing with frequent or severe headaches, you should consult with your physician. While a definite diagnosis may be identified, some patients find themselves frustrated with an unclear answer. And treatment should target more than symptoms: The steady use of pain medication creates side effects that may include kidney damage or dependency.

The Missing Link

Your dentist may be able to shed a little light on chronic head pain. Millions of Americans struggle with temporomandibular joint (TMJ) headaches without realizing it. This complex joint allows the lower jaw to fit and function against the skull in front of the ears, and one or both joints may become inflamed. Unfortunately, TMJ headaches are frequently overlooked by physicians because symptoms often mimic other types of headaches. The pain may feel like it’s in the sinuses, over the top of the head, or up through the temples. But pain doesn’t always show up at the source. It often radiates to nearby sites and confuses the search for an origin.

A recent study at the University of Buffalo examined nearly 600 patients with TMJ pain symptoms. Researchers demonstrated that in 82% of subjects, physical pressure over the TMJ area produced pain that presented as a classic muscle tension headache. Although TMJ symptoms were present in all participants, 152 were diagnosed with tension headaches only.

That means 25% of the patients hadn’t received a complete diagnosis.

The lead researcher noted that “TMJ is very treatable, but if a jaw disorder is ignored, then treatment for a headache may not address all of the factors contributing to the headache.” Many providers evaluating headache patients don’t understand the relationship of these joints to chronic pain conditions. It’s simply vital that every headache sufferer receives an evaluation of this region.

While migraine headaches are linked to a vascular cause, TMJ disorders can aggravate the Trigeminal nerve and trigger their onset. This major nerve links many structures in the head and neck. While not a guarantee, migraine headaches may be reduced with proper management of these associated problems.

Consider This

Review the following questions to see if your headaches may be linked to a TMJ disorder. Keep your answers to discuss with Dr. Falvey:

• Do you wake up with headaches?
• Does your jaw ever feel stiff, locked, or sore in the morning?
• Do you have more than two headaches each week?
• Do you have pain in your jaw when you eat?
• Do you take painkillers four or more times each week for headaches?
• Does your jaw pop, click, or lock when you open?
• Have you noticed any changes in the way your teeth bite together?
• Have you noticed wear or chipping on any of your teeth?
• Do you catch yourself clenching your teeth during the day?
• Do you feel tenderness when you push on the sides of your face?
• Do you feel pain in front of your ears when you chew or open wide?

If you answered YES to three or more of these questions, there’s a significant chance that you’re suffering from TMJ headaches. But management of this affliction frequently involves conservative measures offering dramatic relief from pain. Dr. Falvey’s experience with TMJ headache disorders includes focusing on the cause of the problem, not just the symptoms.  We’re here to help you or your loved ones discover optimal health and pain-free living!

Kids reach many milestones as they grow, including frequent visits from the tooth fairy. A series of developmental steps cause baby teeth to fall out and adult teeth to replace them. But sometimes adults lose permanent teeth from disease or trauma. Modern dentistry presents options for every unfortunate scenario, restoring full function and appearance. We enjoy techniques and materials today for tooth replacement not available in previous generations. Yet dental scientists continue their reach for new horizons and innovative possibilities.

Tufts School of Dental Medicine researchers are harvesting stem cells that grow new teeth and jaw bone. These “universal cells,” taken from inside healthy adult teeth, differentiate into tooth buds. But this intricate process of cellular differentiation only takes place under conditions that replicate an embryonic jaw. Growth hormones and nutrients must stimulate development at exactly the right times. As a result, new teeth won’t grow in a petri dish. They need a precise framework, one which the Tufts researchers continue to design.

Progress Continues

Dental implants are currently the closest alternative to growing a new tooth.

The Tuft’s team recently constructed a cellular matrix that allows successful implantation of a tooth bud into a pig’s jaw. Under their design, early adult-stage teeth develop within five months. But the transfer from pigs to humans requires significant advancements yet to come. Researchers project that humans won’t profit from these developments for another ten years. The exciting progress hints at options once believed to be impossible.

In the meantime, dental implants offer the closest alternative to growing new teeth. Titanium pieces placed into the jawbone mimic tooth roots that support life-like porcelain crowns. And research has brought major benefits to implant technology as well. Specialized coatings and modified designs help produce outstanding integration success, while 3D imaging technology allows precise planning of every case.

A Cavity Disappearing Act

Another intriguing frontier in dental research involves dental fillings that stimulate teeth to repair their own damage. Decayed parts of teeth usually are drilled out and restored with various materials. But researchers at Nottingham and Harvard University recently earned recognition from the Royal Society of Chemistry for their innovative approach.

These teams created a filling material that stimulates stem cells to grow dentin, the firm inner layer of every tooth. They’ve also demonstrated the ability to regenerate the internal nerve and blood vessel center of teeth, the pulp. This part of the tooth usually undergoes root canal treatment when it’s infected. Widespread regenerative procedures are a few years off. But these materials could revolutionize the treatment of some common dental problems.

“We are excited about the promise of therapeutic biomaterials for bringing regenerative medicine to restorative dentistry.”

— Kyle Vining. Fellow, Harvard University

Stay tuned!

Research keeps moving dentistry into fascinating new frontiers with solutions once considered impossible. Dental stem cells open doors to future procedures that will someday be commonplace. But you don’t have to wait for life-changing dentistry: Implants and biocompatible restorative materials now offer modern options for full function and beauty. The Paul Falvey DDS team constantly monitors our profession for developments that enhance your experience. We look forward to discussing the fascinating world of biomedical research in dentistry with you at future visits!

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