If you have chronic jaw pain, you may be one of an estimated 10 million Americans suffering from temporomandibular joint disorders (TMD). If so, it's quite possible you're also coping with other health conditions.
TMD is an umbrella term for disorders affecting the temporomandibular (jaw) joints, muscles and adjoining tissues. The most common symptoms are limited jaw function and severe pain. Determining the causes for these disorders can be difficult, but trauma, bite or dental problems, stress and teeth clenching habits seem to be the top factors. Women of childbearing age are most susceptible to these disorders.
In recent years we've also learned that many people with TMD also experience other conditions. In a recent survey of TMD patients, two-thirds reported having three or more other health conditions, the most frequent being fibromyalgia, chronic fatigue syndrome, rheumatoid arthritis or chronic headaches. Researchers are actively exploring if any systemic connections exist between TMD and these other conditions, and how these connections might affect treatment changes and advances for all of them including TMD.
In the meantime, there remain two basic approaches for treating TMD symptoms. The most aggressive and invasive approach is to surgically correct perceived defects in the jaw structure. Unfortunately, the results from this approach have been mixed in their effectiveness, with some patients even reporting worse symptoms afterward.
The more conservative approach is to treat TMD orthopedically, like other joint problems. These less invasive techniques include the use of moist heat or ice to reduce swelling, physical therapy and medication to relieve pain or reduce muscle spasming. Patients are also encouraged to adopt softer diets with foods that are easier to chew. And dentists can also provide custom-fitted bite guards to help ease the stress on the joints and muscles as well as reduce any teeth grinding habits.
As we learn more about TMD and its relationship to other health conditions, we hope to improve diagnosis and treatment. Until then, most dentists and physicians recommend TMD patients try the more conservative treatments first, and only consider surgery if this proves unsatisfactory. It may take some trial and error, but there are ways now to ease the discomfort of TMD.
If you would like more information on the causes and treatments of 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.”
If you're one of the millions of people wearing an oral appliance, you already know how important it is to your dental health. Whatever the purpose—replacing teeth, stopping teeth grinding or guarding against injury—you want to get the most and longest service from it. That means showing your appliance some tender loving care on a regular basis.
It doesn't require a lot of time and effort to clean and maintain your oral appliance. But there are some pitfalls that could lead to greater wear and tear and just outright damage. Here are 3 things you should be on the alert for to keep your appliance doing its job for you.
Be careful how you clean it. Your appliance might resemble natural oral tissue, but it's not—so don't use toothpaste. Toothpaste contains abrasives, which are fine for tooth enamel but damaging to materials in your appliance. Instead, use dish detergent, hand soap or a specialized cleaner. Don't use hot or boiling water, which could soften any plastic and distort the appliance's mouth fit. Nix the bleach too, which can fade colored portions of the appliance that mimic gum tissue.
Don't wear them 24/7 unless your dentist advises. Depending on the type and function of your appliance, you shouldn't wear them around the clock unless your dentist advises otherwise. Dentures are usually removed at night while you sleep to help prevent bacterial growth. Keeping them out at night -and keeping them clean—will help lower your risk of dental disease. One caveat, though: there are some concerns today about the effect of keeping dentures out of the mouth at night on sleep apnea. It's a good idea, then, to discuss the issue with your dentist regarding taking dentures out at night.
Prevent accidental drops on hard surfaces. Chewing forces are considerable, but your appliance is designed to take it. The same can't be said, though, if they accidentally fall on a hard surface—the fall could crack or break them. To protect against this, be sure to put a soft towel or cloth in your sink basin while you're cleaning your appliance. And don't place it on a night stand or low surface where it could be knocked off accidentally by a child, a pet or you. A sudden accident like this could be costly.
If you would like more information on extending the life of your oral appliance, 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 “10 Tips for Cleaning Your Oral Appliance.”
The Golden Globes ceremony is a night when Hollywood stars shine their brightest. At the recent red-carpet event, leading man Viggo Mortensen had plenty to smile about: Green Book, the movie in which he co-starred, picked up the award for Best Motion Picture—Musical or Comedy. But fans looking at the veteran actor's big smile today might not realize that it once looked very different. A few years ago, an accident during the filming of The Two Towers took a major chip out of Mortensen's front tooth!
That might be OK for some movies (think The Hangover or Dumb and Dumber)—but it's not so great for everyday life. Fortunately, Mortensen visited a dentist promptly, and now his smile is picture-perfect. How was that accomplished? He didn't say…but generally, the best treatment for a chipped tooth depends on how much of the tooth's structure is missing.
If the tooth has only a small chip or crack, it's often possible to restore it via cosmetic bonding. This procedure can be done right in the dental office, frequently in a single visit. Here's how it works: First the tooth is cleaned and prepared, and then a tooth-colored resin is applied to the area being restored. After it is cured (hardened) with a special light, additional layers may be applied to build up the missing structure. When properly cared for, a tooth restored this way can look good for several years.
For a longer-lasting restoration, veneers may be recommended. These are wafer-thin shells made of durable material (most often porcelain) that cover the front (visible) surfaces of teeth. Strong and lifelike, veneers can match the exact color of your natural teeth—or give you the bright, high-wattage smile you've always wanted. No wonder they're so popular in Hollywood! Because veneers are custom-made for you, getting them may require several office visits.
If a chip or crack extends to the inner pulp of the tooth, a root canal procedure will be needed to keep the tooth from becoming infected—a situation that could have serious consequences. But you shouldn't fear a root canal! The procedure generally causes no more discomfort than filling a cavity (though it takes a little longer), and it can help save teeth that would otherwise be lost. After a root canal, a crown (cap) is generally needed to restore the visible part of the tooth.
When a damaged tooth can't be restored, it needs to be extracted (removed) and replaced. Today's best option for tooth replacement is a dental implant—a small, screw-shaped post inserted into the bone of your jaw that anchors a lifelike, fully functional crown. Implants require very little special care and can look great for many years, making them a top choice for tooth replacement
If you have questions about chipped or damaged teeth, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Artistic Repair Of Front Teeth With Composite Resin” and “Porcelain Veneers.”
The term “makeover” is a powerful word in today’s society. It’s used for a variety of things — hair, body, lawn — that need more than a different style, a little toning or some new shrubs. A makeover is a transformation, replacing the dissatisfying status quo with something new and dynamic.
Your smile and its various components — teeth, gums, jaw structure and facial features — might also be a candidate for a makeover. This involves more than just a few modifications. It’s the answer to a smile we avoid showing in photos, cover with our hand when we’re speaking or laughing, or makes us feel older than we really are. In other words, it’s a comprehensive change to a smile that inhibits us from fully expressing ourselves in our friend, family or career relationships.
Of course, for any makeover to succeed, it must follow a plan. A smile transformation is no different. The process begins with what we call a “smile analysis”: a comprehensive examination that determines the exact condition of your entire mouth. This enables us to identify problems and defects, understand how they interact with your other facial features, and then recommend a treatment plan that effectively addresses these issues.
The plan isn’t complete, though, without your input. You may want a complete renovation — to restore missing teeth or change their shape, color and brilliance. On the other hand, you may be more comfortable with a few subtle changes, perhaps even keeping slight imperfections that you see as part of the real “you.” Whichever path you take, the end result is a smile that makes you happy, and proud to show to others.
The various techniques and materials available through cosmetic or restorative dentistry can turn any disappointing smile into a beautiful one. Your journey to that newer, brighter smile begins with your next dental visit.
If you would like more information on smile makeovers through restorative or cosmetic dentistry, 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 “The Impact of a Smile Makeover.”
A loose adult tooth isn't normal. It could be loose because it's been subjected to high biting forces like those that occur with a tooth grinding habit. Or, it could be the result of periodontal (gum) disease or some other infection that has weakened some of the tooth's supporting gums and bone. Whatever the underlying cause, we'll need to act quickly to save your tooth.
Our first step is to find out this exact cause—that will determine what treatment course we need to follow. For a tooth grinding habit, for example, you might need to wear an occlusal guard or have your bite (teeth) adjusted. With gum disease, we'll focus on removing dental plaque, the thin film of bacteria and tartar (calculus) fueling the infection. This stops the infection and minimizes any further damage.
While we're treating the cause, we may also need to secure the loose tooth with splinting. This is a group of techniques used to join loose teeth to more stable neighboring teeth, similar to connecting pickets in a fence. Splinting can be either temporary or permanent.
Temporary splinting usually involves composite materials with or without strips of metal to bond the loose tooth to its neighbors as the periodontal structures heal. Once the tooth's natural attachments return to health, we may then remove the splint.
There are a couple of basic techniques we can use for temporary splinting. One way is to bond the splint material to the enamel across the loose tooth and the teeth chosen to support it (extra-coronal splinting). We can also cut a small channel across all the affected teeth and then insert metal ligatures and bond the splint material within the channel (intra-coronal).
If we're not confident the loose tooth will regain its natural gum attachment, we would then consider a permanent splint. The most prominent method involves crowning the loose tooth and supporting teeth with porcelain crowns. We then fuse the crowns together to create the needed stability for the loose teeth.
Whatever splinting method we use, it's important to always address the root cause for a tooth's looseness. That's why splinting usually accompanies other treatments. Splinting loose teeth will help ensure your overall treatment is successful.
If you would like more information on treating loose teeth, 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 “Treatment for Loose Teeth.”
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