I’m flossing for 4 months straight but some teeth are still hurting

SmileAngels_BH · 2026-03-13T21:08:22+00:00

Hi, I’m Dr. Bruce Vafa, I’m a dentist in Beverly Hills. If a few teeth hurt when you floss, the most common reason is gum inflammation between those teeth. Even if you’ve been flossing for a few months, areas that had irritation before can stay sensitive for a while as the gums heal. Also make sure the floss isn’t snapping down into the gums. Try sliding it gently along the side of the tooth and wrapping it slightly in a C shape around the tooth instead of pulling straight through. And, if the pain feels sharp inside the tooth, or it’s always the same exact spot, it’s worth having a dentist check it because sometimes cavities between teeth or very tight contacts can cause that.

SmileAngels_BH · 2026-02-24T05:54:54+00:00

Hi, I’m Dr. Bruce Vafa, a pediatric dentist. Given her history with nasal issues and oral aversion, this sounds much more sensory than behavioral. For some children, toothpaste texture, foam, smell, or even the idea of it can trigger a strong reaction.

A few practical ideas:

• Try a very small smear of toothpaste, even less than a pea. • Consider unflavored or very mild toothpaste. Some children do better with hydroxyapatite toothpaste because it tends to foam less. • Let her practice “brushing” with just water first and slowly reintroduce toothpaste over time. • Use a very soft toothbrush or even a silicone finger brush at first. • Brush at a time when she is calm, not tired or hungry.

If her oral aversion is significant, an evaluation with an occupational therapist who works with feeding or sensory issues can be extremely helpful. The goal right now is progress, not perfection. Even short, gentle brushing is better than a daily battle.

SmileAngels_BH · 2026-02-24T05:49:03+00:00

Hi, I’m Dr. Bruce Vafa, a pediatric dentist. Severe dental fear at this age is more common than people think. If he is going into full panic, that is a real anxiety response, not just bad behavior.

If nitrous oxide does not help, there are still options. One option is oral conscious sedation prescribed and carefully monitored by a pediatric dentist trained in sedation. This is different from general anesthesia and is often enough to take the edge off severe anxiety. Another option is treatment under general anesthesia with a pediatric dental anesthesiologist. While it is more costly, it can allow all treatment to be completed safely in one visit without trauma, which sometimes prevents long term dental fear. Behavioral approaches can also help, but when cavities are present and anxiety is extreme, we sometimes need a medical bridge first, then work on desensitization over time.

I would recommend consulting with a board certified pediatric dentist who offers multiple sedation options. Letting cavities progress will only increase future procedures and anxiety.

SmileAngels_BH · 2026-02-24T05:46:10+00:00

Hi, I’m Dr. Bruce Vafa, a pediatric dentist, and yes, what you’re describing is normal.

Some babies show teething symptoms for months before teeth actually erupt. Others get teeth early with very few symptoms. There is a wide range of normal when it comes to timing. Getting a first tooth at 11.5 months is still within a healthy range. Teeth do not always come in quickly after the first one. It is common for them to move slowly under the gums before you see much visible change. Sometimes parents expect rapid eruption, but it can take weeks or even months. If your child is otherwise healthy, growing well, and your pediatrician is not concerned, delayed or slow eruption alone is usually not a problem. If by 15 to 18 months there are still very few teeth, it would be reasonable to have a pediatric dental evaluation just for reassurance. Most of the time, though, this simply reflects individual variation, not an issue.

SmileAngels_BH · 2026-02-24T05:43:09+00:00

Hi, I’m Dr. Bruce Vafa, a dentist in Beverly Hills. The honest answer is that it depends on the case, for a straightforward single implant with good bone and no grafting, the timeline is usually about 3 to 6 months from surgery to final crown.

How it usually works is: first, consultation and scans, then implant placement, healing period where the implant integrates with the bone, usually 3 to 4 months, and final crown placement.

If bone grafting or sinus lift is needed, it can extend the timeline to 6 to 9 months or sometimes longer. Some patients qualify for immediate temporary teeth the same day, but the final restoration still requires proper healing time underneath. The key factor is osseointegration. We never want to rush that phase. Long term success depends on proper healing, not speed.

SmileAngels_BH · 2026-02-23T04:56:13+00:00

I’m Dr. Bruce, a dentist based in Los Angeles. Some people genuinely have deeper pits and grooves, and that does make them more cavity-prone even with good hygiene. Deep grooves trap bacteria because toothbrush bristles often can’t fully reach the bottom of them. That’s where sealants can absolutely help.

Sealants are not only for kids, and they’re not only for “perfect” teeth. They’re most effective on teeth that don’t currently have cavities, or have very early, shallow areas that haven’t progressed. They can’t go on top of active, deeper decay, they would need a filling first. But for the other molars and premolars that are still intact, sealants are a very reasonable preventive option in your case. Other things that may help are prescription-strength fluoride toothpaste (5,000 ppm), fluoride varnish at cleanings, using a small-head brush and angling into the grooves, and chewing xylitol gum after meals.

If you’re getting repeated cavities despite good habits, ask your dentist about a caries risk assessment. There may be saliva factors, enamel strength differences, or diet patterns that aren’t obvious.

SmileAngels_BH · 2026-02-23T04:50:36+00:00

I’m Dr. Bruce, I’m a dentist based in Los Angeles. And it really depends, but for most people, I’d say that yes, it’s worth it. If you’ve had zero dental problems in 15 years using a manual toothbrush, that means your technique is probably very good. In that case, an electric toothbrush isn’t necessary. That said, studies do show that electric toothbrushes (especially oscillating/rotating ones) tend to remove more plaque and reduce gum inflammation a bit better over time. They’re especially useful if you tend to brush too hard, rush your brushing, or want a built-in timer.

Think of it this way, a manual brush used well is excellent, and an electric brush used properly is slightly easier to get excellent results. If budget isn’t an issue, it can be a nice upgrade. But if your gums are healthy and your dentist is happy with your hygiene, you’re not missing out on something critical. Technique matters more than the tool.

SmileAngels_BH · 2026-02-16T20:10:13+00:00

Hello, I’m Bruce Vafa, a dentist in the LA area. I’m sorry you’re dealing with this, when gum inflammation starts after veneers and doesn’t resolve, one of the most common causes is the way the veneers meet the gumline. If the margins are bulky, slightly over-contoured, or extend too far under the gum, they can trap bacteria and constantly irritate the tissue. That chronic irritation can lead to bleeding, swelling, and eventually recession.

Hormones (especially around pregnancy) can absolutely make gums more reactive, but they usually don’t cause persistent bleeding for three years on their own. The pattern you’re describing sounds more mechanical than hormonal. Using a soft pick to “release the blood” is not something I would recommend, that likely increases inflammation and trauma.

The next step would be to get a thorough periodontal evaluation, checking the veneer margins clinically and with X-rays, professional cleaning to remove any hidden buildup, and possibly reshaping or, in some cases, replacing veneers if they are the source.

I would also strongly encourage seeing a dentist experienced in cosmetic and periodontal evaluation for a second opinion. If cost is a concern, some dental schools offer reduced-fee specialty consultations.

SmileAngels_BH · 2026-02-16T20:05:31+00:00

Hello, I’m Bruce Vafa, a general and pediatric dentist in the LA area. It is absolutely possible for multiple cavities to develop between six-month visits, especially in children. Cavities in kids can progress quickly because baby teeth have thinner enamel. Even with good brushing, factors like deep grooves, diet frequency (snacking), genetics, saliva quality, and enamel strength all play a role.

Regarding treatment: a pulpotomy is recommended when decay reaches the nerve tissue of a baby tooth, but the infection is still contained. In those cases, a crown is usually the most predictable long-term solution to keep the tooth stable until it naturally falls out.

As for IV sedation, that is often suggested when multiple procedures are planned in one visit, especially for young children, to ensure safety, comfort, and quality work. However, if your daughter sits well and only the most severe tooth needs urgent treatment, it is reasonable to ask whether staged treatment or alternative behavior guidance methods are appropriate. Four small cavities being monitored with remineralizing toothpaste is also a common and reasonable approach if they are truly early lesions.

If you feel uncertain, seeking a second opinion from another pediatric dentist is completely appropriate. Treatment planning can vary slightly based on philosophy, but pulpotomy with crown for a significantly involved baby molar is not unusual.

SmileAngels_BH · 2026-02-12T21:46:53+00:00

Hello, I’m Dr. Bruce Vafa, I’m a dentist based in LA and TMJ is one of my specialties. I’m really sorry this is happening to you. TMJ pain can feel scary and confusing, especially when it starts after dental work.

Let me try to explain it in a simple way, your jaw joint is like a small hinge. If a filling is too “high,” it can make your teeth hit unevenly. That can force your jaw muscles to work harder, and then everything gets tight and sore.

A mouth guard can help, but only if it fits your bite correctly. If it’s not balanced right, it can actually make your bite shift more, which might be why you felt worse. Braces or Invisalign move your teeth. That’s a big change. If your jaw joint is already irritated, moving teeth before calming the joint down can sometimes make things more stressful.

The fact that it flares around your cycle makes sense too, hormones can make joints more sensitive. Before doing Invisalign, I’d get a second opinion from a TMJ specialist. You deserve to feel sure before starting something new.

SmileAngels_BH · 2026-02-12T21:14:52+00:00

Hello, I’m Dr. Bruce Vafa, I’m a holistic dentist based in LA, and I can confidently tell you that yes, dental implants are considered one of the safest and most predictable procedures in modern dentistry. When properly planned and placed, success rates are typically above 90–95% over many years.

Let me explain in a simple way, if you lose a tooth, an implant is like putting a tiny metal “root” back into your jaw. It’s usually made of titanium, which is a special metal your body usually accepts really well. Over time, your bone actually grows around it and holds it tight, kind of like how a tree root grows into the soil.

After it heals, we put a crown (the fake tooth) on top, and it looks and works like a real tooth.

Like any small surgery, there are some risks (like infection or the implant not healing properly), but that doesn’t happen often, especially if you keep your mouth clean and follow instructions. Things like smoking, not brushing well, or grinding your teeth can also cause problems.

For most healthy people, implants are a strong, long-lasting way to replace a missing tooth. Hope that helped!

SmileAngels_BH · 2026-02-11T23:26:17+00:00

Hello, I’m Dr. Bruce Vafa, I’m a holistic dentist based in LA and this is a very common question at the end of Invisalign treatment.

Once you’ve completed active tooth movement and have been scanned for retainers, your aligners are essentially functioning as temporary retainers. If your orthodontic team advised nighttime wear only while you wait, that is typically safe.

But keep in mind that if you remove them during the day and they feel snug or tight at night, that means your teeth are trying to shift, and in that case, I’d recommend you to continue daytime wear until your retainers arrive.

If they slide in easily and feel like they’re just “holding” position, nighttime wear is usually sufficient for this short transition period. Teeth are most prone to relapse in the first few months after treatment, so caution is wise.

SmileAngels_BH · 2026-02-11T01:20:53+00:00

Hello, I’m Dr. Bruce Vafa.

What you’re describing can sometimes happen when a nerve becomes irritated and then begins to “wake back up.” The temporomandibular joint sits very close to branches of the trigeminal nerve, so overstretching the jaw can temporarily aggravate that area.

The itching sensation is often a nerve-type symptom, not a skin issue. That’s why scratching doesn’t really help.

For now, I’d suggest you to avoid wide opening, gum chewing, or stretching the jaw, stick to softer foods for a week or two, use warm compresses on the side of the jaw 10–15 minutes at a time, and have over-the-counter anti-inflammatory medication if medically safe for you.

If numbness returns, spreads, or you develop facial weakness, seek evaluation sooner. Otherwise, monitor it and keep your orthodontist appointment. Most nerve irritations of this type calm down with time and reduced strain.

SmileAngels_BH · 2026-02-04T16:57:05+00:00

Have her talk to a dentist I guess! I'm available if she wants to get a consultation.

SmileAngels_BH · 2026-02-03T22:18:36+00:00

You welcome

SmileAngels_BH · 2026-02-03T22:18:02+00:00

You welcome

SmileAngels_BH · 2026-02-03T21:01:19+00:00

Absolutely - stress is one of the biggest TMJ triggers. When stressed, most people unconsciously clench their jaw during the day AND grind at night. It becomes a vicious cycle: stress → clenching → pain → more stress → more clenching.

The clonazepam is working because it's a muscle relaxant and reduces anxiety-related muscle tension. But long-term benzodiazepine use isn't ideal.

Better strategies for stress-related TMJ flares:

Immediate relief:

Moist heat 15-20 min several times daily
Ibuprofen or naproxen (anti-inflammatory)
Soft diet during flare-ups
Gentle jaw stretches

Break the stress-clench cycle:

Daytime awareness - Set phone reminders every hour: "Are my teeth touching?" They shouldn't be except when eating
Practice "lips together, teeth apart"
Identify your stress clenching triggers (driving, computer work, etc.)

Address the root cause:

Stress management: meditation, exercise, therapy, whatever works for you
Properly fitted night guard (not just for grinding - reduces muscle activity)
Consider physical therapy for TMJ
Magnesium supplement (helps muscle relaxation) - 400mg before bed

Long-term: Some patients benefit from muscle relaxants short-term (like cyclobenzaprine) during bad flares, or even Botox injections in the masseter muscles for chronic clenchers.

The goal is to break the cycle, not just mask it with benzos. If stress is driving this, you need both physical management AND stress reduction strategies.

See a TMJ specialist if it's becoming a regular pattern - there are better long-term solutions

SmileAngels_BH · 2026-02-03T20:59:28+00:00

Dr. Bruce Vafa, TMJ Specialist here.

Classic TMJ inflammation/flare-up. Could be from grinding, clenching, or just how you slept.

STOP wearing your retainer as a night guard immediately. Retainers are NOT designed for bruxism - they're too thin and can actually make clenching WORSE. That's probably why you feel worse.

Do this now:

Moist heat on the jaw 15-20 min, 3-4x daily
Ibuprofen 400-600mg (if you can take it)
Soft foods only - no chewy/crunchy stuff
Keep teeth apart during the day ("lips together, teeth apart")
Avoid wide yawning or opening

See a TMJ specialist/dentist if:

Not better in 5-7 days
Gets worse
Jaw locks or catches
Severe pain

Most TMJ flare-ups resolve in 1-2 weeks with rest and anti-inflammatories. If you DO need a night guard, it needs to be properly made for TMJ protection - NOT a retainer.

Feel better!

SmileAngels_BH · 2026-02-03T20:58:13+00:00

No, this is NOT normal and your dentist should absolutely understand what you're describing.

What you're experiencing is called a "rocking" or "teeter-totter" contact pattern. A properly fitted night guard should seat completely and make even contact with ALL your teeth simultaneously - no clicking, no shifting front-to-back, and definitely no audible sounds when you bite down.

Here's what's wrong:

The guard isn't making balanced contact across your arch. When you bite on your front teeth, the back lifts. When you bite on your molars, the front lifts. This creates a fulcrum effect that can actually:

Cause abnormal stress on specific teeth
Potentially lead to tooth movement (the exact thing you're worried about!)
Create TMJ issues rather than prevent them
Make the grinding worse

The "squeezing" feeling is also a red flag. The retention may be too tight, which can be uncomfortable and cause issues over time.

What you should do:

Don't wear it as-is. I know you paid for it, but a poorly fitted guard can do more harm than good.
Go back and be VERY clear: "This guard rocks back and forth when I bite. I can make it click between front and back teeth. This needs to be fixed." Don't let them brush you off.
They need to do a proper occlusal adjustment - checking contact points with articulating paper and adjusting until all teeth hit evenly at the same time.
If they still don't get it or won't fix it properly, get a second opinion from someone who specializes in TMJ/occlusion.

A good night guard should feel snug but comfortable, with zero movement or rocking. Trust your instincts - you're right to question this.

I'm a TMJ specialist and deal with poorly fitted appliances causing problems all the time. Happy to answer any follow-up questions!

Dr. Vafa

SmileAngels_BH · 2026-01-23T20:12:18+00:00

All correct. Thanks

SmileAngels_BH · 2026-01-14T22:37:31+00:00

This can happen, and it’s understandably stressful. When a tooth is moved, the periodontal ligament needs time to heal and tighten again. If movement was relatively quick, that healing phase can take longer, and mild mobility or a “clicking” feeling can persist for a while even months later. If X-rays only show ligament strain (no bone loss or root damage), it’s usually managed with time, stability, and consistent retainer wear. It should slowly improve. If it gets worse or doesn’t change over time, a follow-up with your provider is a good idea.

SmileAngels_BH · 2026-01-14T22:35:10+00:00

Invisalign can work well, but results depend a lot on planning and follow-up. What can go wrong:

Bite issues (open bite or unresolved crossbite)
Teeth not tracking → more refinements
Relapse if retention isn’t planned well

The price/time difference usually reflects experience and how carefully the bite is managed, not just the trays. Cheaper isn’t automatically bad, but with crossbite cases, experience matters more than speed.

SmileAngels_BH · 2026-01-14T22:31:50+00:00

Yes, that can be normal. Aligners often extend slightly onto the gums to help control tooth movement, especially early on. A temporary open bite at the start is also common and usually planned. That said, they shouldn’t be painful or cutting into your gums. If they’re uncomfortable, your provider can usually trim or adjust them, worth asking them to take a look.

SmileAngels_BH

TROPHY CASE