Vivian Medina, DDS

Dr. Vivian Medina is a graduate of Creighton University. After working as an associate for several years, she opened a private practice in 1993.

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3630 Madaca Ln.,
Tampa, FL 33618
(813) 264-0286
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Posts for category: Oral Health

By Vivian Medina, DDS
May 06, 2019
Category: Oral Health
Tags: toothache  
YourToothacheMightnotbeCausedbyaTooth

A toothache means a tooth has a problem, right? Most of the time, yes: the pain comes from a decayed or fractured tooth, or possibly a gum infection causing tooth sensitivity.

Sometimes, though, the pain doesn't originate with your teeth and gums. They're fine and healthy—it's something outside of your tooth causing the pain. We call this referred pain—one part of your body is sending or referring pain to another part, in this instance around your mouth.

There are various conditions that can create referred pain in the mouth, and various ways to treat them. That's why you should first find out the cause, which will indicate what treatment course to take.

Here are a few common non-dental causes for tooth pain.

Trigeminal Neuralgia. The trigeminal nerves situated on either side of the face have three large branches that extend throughout the face; the branch to the jaw allows you to feel sensation as you chew. When one of the nerve branches becomes inflamed, usually from a blood vessel or muscle spasm pressing on it, it can refer the pain to the jaw and seem like a toothache.

Temporomandibular Joint Disorder (TMD). These two joints that connect the lower jaw to the skull can sometimes become dysfunctional for a variety of reasons. This can set up a cycle of spasms and pain that can radiate throughout the jaw and its associated muscles. The pain can mimic a toothache, when it actually originates in the jaw joints.

Teeth Grinding. This is an unconscious habit, often occurring at night, in which people clench or grind their teeth together. Although quite common in children who tend to grow out of it, teeth grinding can continue into adulthood. The abnormally high biting forces from this habit can cause chipped, broken or loosened teeth. But it can also cause jaw pain, headaches and tenderness in the mouth that might feel like a toothache.

These and other conditions unrelated to dental disease can seem like a tooth problem, when they're actually something else. By understanding exactly why you're feeling pain, we can then focus on the true problem to bring relief to your life.

If you would like more information on oral pain issues, please contact us or schedule an appointment for a consultation.

ModerateYourChildsJuiceDrinkingtoLowerToothDecayRisk

Along with daily brushing and flossing, limiting your child’s sugar consumption is an important way to prevent tooth decay. We all know the usual suspects: candy, sugar-added snacks and sodas. But there’s one category you may not at first think fits the profile—juices. But even natural juices with no added sugar can raise your child’s risk of tooth decay if they’re drinking too much.

Tooth decay is caused by certain strains of bacteria in the mouth, which produce acid. Sugar in any form (sucrose, fructose, maltose, etc.) is a primary food source for these bacteria. When there’s a ready food source, bacteria consume it and produce abnormally high levels of acid. This can cause the mineral content of tooth enamel to dissolve faster than saliva, which neutralizes acid, can reverse the tide.

Juices without added sugar still contain the natural sugar of the fruit from which they originate. The American Academy of Pediatrics conducted a study of the effect of these natural juice sugars on dental health. Their conclusion: it can have an effect, so the amount of juice consumed daily by a child should be restricted according to age.

They’ve since published guidelines to that effect:

  • Under age 1 (or any child with abnormal weight gain): no juice at all;
  • Ages 1-3: no more than 4 ounces a day;
  • Ages 4-6: no more than 6 ounces a day;
  • Ages 7-18: no more than 8 ounces (1 cup) a day.

Again, these are guidelines—you should also discuss the right limits for your individual child with your dentist or pediatrician. And if you’re wondering what kind of beverages pose less risk of tooth decay, you can look to low or non-fat milk. And, of course, don’t forget water—besides containing no sugar, nature’s hydrator has a neutral pH, so it won’t increase acidity in the mouth.

Tooth decay is one of the biggest health problems many kids face. But with good teeth-friendly habits, including restricting sugar intake in any of its many forms (including juices) you can go a long way in reducing their risk of this destructive disease.

If you would like more information on best dental care practices for children, please contact us or schedule an appointment for a consultation.

By Vivian Medina, DDS
March 27, 2019
Category: Oral Health
Tags: dental anxiety  
3WaystoTaketheJittersOutofDentalVisits

Dental anxiety is a common problem: it’s estimated that one in two Americans admits to some level of nervousness about seeing the dentist. On the extreme side of this statistic about 15% of the population even avoid or postpone dental care because of it. While comedy shows routinely make fun of people’s fear of the dentist, the consequences of not receiving needed dental care due to dental anxiety are no laughing matter.

Fortunately, visiting the dentist doesn’t have to be a nerve-wracking, butterflies-in-the-stomach experience. Here are 3 ways to make sure your next visit is more pleasant.

The right dentist. Dental care is more than technical—it’s also personal and relational. The most important element for reducing dental visit anxiety is a provider you’re comfortable with and that you trust. It’s especially important for high anxiety patients to find a dentist who also has compassion for how they feel and won’t judge them—instead, working with them to find just the right combination of techniques and possible medications that encourage relaxation.

Oral sedation. For many people nervous about dental visits the answer could be prescribed sedation medication taken an hour or so before their appointment. Typically a mild sedative, the dose is just enough to help them relax. It’s also often coupled with other methods like nitrous oxide or local anesthesia for a pain-free and unstressed experience.

IV sedation. For people with high levels of anxiety, it’s often beneficial to increase the level of sedation. One of the best ways to do this is with an intravenous flow of medication that will place a person in a deeper state of relaxation. Although this method requires careful vital sign monitoring during the procedure, it’s often the best way to calm patients with high anxiety so they can receive the dental care they need.

Working with your dentist, you can develop just the right mix of these and other methods for making your dental visits easier. No matter what your level of anxiety, you don’t have to avoid the dentist nor needed dental care.

If you would like more information on reducing anxiety during dental visits, 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 “IV Sedation in Dentistry.”

By Vivian Medina, DDS
January 16, 2019
Category: Oral Health
Tags: jaw pain  
ChronicJawPainCouldbeRelatedtoOtherInflammatoryConditions

If you're suffering from jaw pain or impaired function, it may not be the only source of chronic pain in your body. Of the millions of adults with temporomandibular joint disorders (TMD), many have also been diagnosed — among other conditions — with fibromyalgia, rheumatoid arthritis or sleep problems.

TMD is actually a group of painful disorders that affect the jaw joints, muscles and surrounding tissues. Besides pain, other symptoms include popping, clicking or grating sounds during jaw movement and a restricted range of motion for the lower jaw. Although we can't yet pinpoint a definite cause, TMD is closely associated with stress, grinding and clenching habits or injury.

It's not yet clear about the possible connections between TMD and other systemic conditions. But roughly two-thirds of those diagnosed with TMD also report three or more related health conditions. Debilitating pain and joint impairment seem to be the common thread among them all. The similarities warrant further research in hopes of new treatment options for each of them.

As for TMD, current treatment options break down into two basic categories: a traditional, conservative approach and a more interventional one. Of the first category, at least 90% of individuals find relief from treatments like thermal therapy (like alternating hot and cold compresses to the jaw), physical therapy, medication or mouth guards to reduce teeth clenching.

The alternative approach, surgery, seeks to correct problems with the jaw joints and supporting muscles. The results, however, have been mixed: in one recent survey a little more than a third of TMD patients who underwent surgery saw any improvement; what's more alarming, just under half believed their condition worsened after surgery.

With that in mind, most dentists recommend the first approach initially for TMD. Only if those therapies don't provide satisfactory relief or the case is extreme, would we then consider surgery. It's also advisable for you to seek a second opinion if you're presented with a surgical option.

Hopefully, further research into the connections between TMD and other inflammatory diseases may yield future therapies. The results could help you enjoy a more pain-free life as well as a healthy mouth.

If you would like more information on TMD, 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 “Chronic Jaw Pain and Associated Conditions.”

By Vivian Medina, DDS
December 27, 2018
Category: Oral Health
Tags: oral health   tooth decay   nutrition  
TakeStepstoReduceMouthAcidandAvoidDentalErosion

Your teeth’s hard, enamel coating protects them from environmental dangers or disease. But although it’s made of the hardest substance in the human body, enamel isn’t invincible — prolonged exposure to acid can cause dental erosion, a condition in which the enamel’s mineral content permanently dissolves, a process known as de-mineralization.

De-mineralization occurs anytime our mouth environment becomes too acidic due to eating or drinking items with high acid content. Saliva normally neutralizes mouth acid in thirty minutes to an hour after we eat, as well as restores mineral content to the enamel (re-mineralization). Danger arises, though, if the saliva’s buffering action is overwhelmed by chronic acidity, caused mainly by constant snacking or sipping on acidic foods and beverages throughout the day — in this situation, saliva can’t complete the process of buffering and re-mineralization.

As a result, the enamel may permanently lose its mineral content and strength over time. This permanent dental erosion leads to serious consequences: the teeth become more susceptible to decay; the dentin becomes exposed, which causes pain and sensitivity to pressure and temperature changes; and changes in the teeth’s size and color can negatively alter your appearance.

It’s important to take action then before dental erosion occurs. Along with daily oral hygiene, restrict your consumption of acidic foods and beverages to meal times and cut back on between-meal snacks. Rather than a sports drink after exercising, drink nature’s hydrator — water. You should also alter your brushing habits slightly — rather than brush right after you eat, wait thirty minutes to an hour. This gives saliva time to restore the mouth to its normal pH and re-mineralize the enamel. Brushing right after can remove even more of the minerals in softened enamel.

If significant erosion has occurred, there are a number of treatment options we can undertake to preserve remaining tooth structure and enhance your appearance. In moderate cases, we can reshape and cover damaged teeth using dental materials like composite resins or porcelain to fill decayed areas or cover teeth with veneers or crowns.

The key of course, is to identify dental erosion through clinical examination as soon as possible to minimize damage. Your enamel plays a critical role in protecting your teeth from disease — so take the right steps to protect your enamel.

If you would like more information on protecting your enamel, 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 “Dental Erosion.”



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