After ruling out other causes for your jaw pain, your doctor or dentist has made a diagnosis: a temporomandibular joint disorder (TMD). With TMD, your pain symptoms and other dysfunctions are due to a problem associated with the temporomandibular joint (TMJ) that connects your lower jaw (mandible) to your upper skull (cranium).
There are a number of treatment options, but most can be classified as either aggressive or conservative. Aggressive treatments are more interventional and target problems with the teeth such as bite problems or jaw relationships as they relate to the bite, which are thought to be underlying causes for TMD. Such treatments include orthodontics to realign teeth, crown or bridgework, or surgical treatment to the jaw or joint itself. These treatments are controversial and irreversible — with no guarantee of symptom relief.
It’s thought by many to be appropriate, then, to start with more conservative treatments. Many of these are based on treating the TMJ — which is a joint, a moveable bony structure connected by muscles and tendons — with an orthopedic approach, using treatments similar to those used for other joint problems.
Here, then, are some of those conservative therapies that may relieve your TMD pain and other symptoms.
Physical Therapy. Commonly used to treat pain and dysfunction in other joints, physical therapies like manual manipulation, massage, alternating hot and cold packs or exercises can be used to relax, stretch or retrain the muscles that operate the TMJ while reducing pain and inflammation.
Medications. Medications may be incorporated into the treatment plan to relieve pain, reduce inflammation or relax tense muscles. Besides prescription drugs, over-the-counter anti-inflammatory drugs (such as ibuprofen or acetaminophen) are also commonly used.
Bite Appliances. If night-time teeth grinding or clenching habits are a primary cause for the TMD, you may benefit from wearing an occlusal bite guard while you sleep, designed to specifically fit your upper teeth. Because the lower teeth can’t grip the guard’s smooth plastic surface when biting down, they’ll more likely produce less force. This gives the jaw muscles a chance to relax during sleep.
Diet changes. Changing to softer foods, which don’t require strenuous chewing, and eliminating the chewing gum habit will further help reduce stress on the TMJs and also give your muscles a chance to relax and heal.
If you would like more information on TMD and treatment options, 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 “Seeking Relief from TMD.”
One of the most important aspects of social interaction is smiling, showing others we’re confident and outgoing. Â Many people, though, are hesitant to use this important social skill because their teeth are unattractive.
But even the most unattractive teeth can be dramatically transformed through cosmetic dentistry. Here are 5 prominent ways we can restore beauty to your problem teeth.
Enamel shaping. Sometimes teeth can have an irregular shape that makes them stand out like a sore thumb. With this “sculpting” technique, we remove very small amounts of enamel, the outer protective layer of a tooth, which improves the tooth’s overall shape without harming it.
Bonding. Recent developments in acrylics now make it easier to repair chipped, broken or decayed teeth with minimal preparation. The acrylic material can be molded to resemble a natural tooth and colored to precisely match its shade and that of neighboring teeth. It’s then bonded to the tooth with a durability that can last through years of daily biting and chewing.
Veneers. These thin layers of dental porcelain are bonded to teeth to cover minor defects. Otherwise healthy teeth that are slightly chipped, stained or a bit out of alignment can get a more attractive “face” that’s durable and lasting.
Crowns and Bridgework. Sometimes teeth are too heavily decayed or lost altogether to use bonding or veneers. With porcelain dental restorations that have a strong inner core and an outer life-like appearance, we can completely cover an individual damaged tooth with a custom-made crown or replace one or more missing teeth with fixed bridgework.
Dental Implants. Introduced over thirty years ago, implants are a popular tooth replacement choice. Â Its inner titanium post is surgically inserted into the jaw where bone cells grow and adhere to it to form a strong, lasting bond. Implants can be used for single teeth or as supports for fixed bridgework or removable dentures.
Regardless of your teeth’s appearance problems, cosmetic dentistry has a solution. The first step is a comprehensive examination — from there we can advise you on the best options for turning your embarrassing smile into a more beautiful and confident one.
If you would like more information on the various techniques for smile transformation, 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 “Beautiful Smiles by Design.”
There are several reasons why dental implants are so popular. Perhaps the most important, though, is their longevity: if maintained properly implants can last for decades. However, they’re not indestructible—certain mouth conditions could put them at risk for early failure. But if you address emerging problems early, you may be able to prevent that unfortunate outcome.
Your implants may be in danger, for example, if you have a teeth grinding or clenching habit. This occurs when a person involuntarily and repeatedly bites down on their teeth when not chewing or speaking. Usually triggered in adults by high stress, teeth grinding can subject both natural teeth and implants to damaging levels of force. Over time this can cause bone loss around an implant and weaken their support. It could also cause a direct break in an implant.
But there are ways to stop or at least reduce the effects of teeth grinding. One effective way is a custom-made bite guard you wear while you sleep. Made of hard plastic, the guard prevents the teeth from making solid contact with each other, reducing the amount of force generated.
A more prominent problem is periodontal (gum) disease, a bacterial infection caused by built-up dental plaque on tooth surfaces. This can trigger inflammation, a normal defensive response that when it persists for an extended period of time can damage tissues and supporting bone. It can also cause a specific form of gum disease related to implants called peri-implantitis, in which the tissues that support an implant become infected and weaken, leading eventually to possible implant failure.
If you have implants, then, you should brush and floss daily to prevent gum disease, as well as see your dentist at least every six months for cleanings and checkups. And if you notice anything like reddened, swollen or bleeding gums, see your dentist immediately. The sooner you undergo treatment, the better the outcome for your implants as well as your overall health.
Dental implants can give you years of great service and can prove to be well worth the cost. But you’ll have to stay on your guard against gum disease and other mouth conditions that could endanger them down the road.
If you would like more information on dental implants, 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 Implants: A Tooth-Replacement Method that Rarely Fails.”
Everyone loves a concert where there's plenty of audience participation… until it starts to get out of hand.Â Recently, the platinum-selling band Fifth Harmony was playing to a packed house in Atlanta when things went awry for vocalist Camila Cabello. Fans were batting around a big plastic ball, and one unfortunate swing sent the ball hurtling toward the stage — and directly into Cabello's face. Pushing the microphone into her mouth, it left the “Worth It” singer with a chipped front tooth.
Ouch! Cabello finished the show nevertheless, and didn't seem too upset. “Atlanta… u wild… love u,” she tweeted later that night. “Gotta get it fixed now tho lol.” Fortunately, dentistry offers a number of ways to make that chipped tooth look as good as new.
A small chip at the edge of the tooth can sometimes be polished with dental instruments to remove the sharp edges. If it's a little bigger, a procedure called dental bonding may be recommended. Here, the missing part is filled in with a mixture of plastic resin and glass fillers, which are then cured (hardened) with a special light. The tooth-colored bonding material provides a tough, lifelike restoration that's hard to tell apart from your natural teeth. While bonding can be performed in just one office visit, the material can stain over time and may eventually need to be replaced.
Porcelain veneers are a more long-lasting solution. These wafer-thin coverings go over the entire front surface of the tooth, and can resolve a number of defects — including chips, discoloration, and even minor size or spacing irregularities. You can get a single veneer or have your whole smile redone, in shades ranging from a pearly luster to an ultra-bright white; that's why veneers are a favorite of Hollywood stars. Getting veneers is a procedure that takes several office visits, but the beautiful results can last for many years.
If a chip or crack extends into the inner part of a tooth, you'll probably need a crown (or cap) to restore the tooth's function and appearance. As long as the roots are healthy, the entire part of the tooth above the gum line can be replaced with a natural-looking restoration. You may also need a root canal to remove the damaged pulp material and prevent infection if the fracture went too far. While small chips or cracks aren't usually an emergency (unless accompanied by pain), damage to the tooth's pulp requires prompt attention.
If you have questions about smile restoration, please contact us and schedule an appointment. You can read more in the Dear Doctor magazine articles “Porcelain Veneers: Strength & Beauty As Never Before” and “Porcelain Crowns & Veneers.”
Bright, naturally white teeth are a key component in a beautiful smile. But the opposite is also true: nothing diminishes an otherwise attractive smile more than stained or discolored teeth.
There is good news, however, about tooth staining: it can be greatly reduced with the right whitening technique. But before taking action we need to first uncover the cause for the staining — whether from the outside or inside of the tooth, or a combination of both.
If it’s an external cause — known as extrinsic staining — our diet is usually the source. Foods and beverages that contain tannins, like red wine, coffee or tea fall in this category, as do foods with pigments called carotenes as found in carrots and oranges. Besides limiting consumption of stain-causing foods and maintaining daily oral hygiene, you can also diminish extrinsic staining with a bleaching application.
There are two basic ways to approach this: with either a professional application at our office or with a home kit purchased at a pharmacy or retail store. Although both types use similar chemicals, the professional application is usually stronger and the whitening effect is obtained quicker and may last longer.
Discoloration can also occur within a tooth, known as intrinsic staining, and for various reasons. It can occur during tooth development, as with childhood overexposure to fluoride or from the antibiotic tetracycline. Poor development of enamel or dentin (the main sources of natural tooth color), tooth decay, root canal treatments or trauma are also common causes of intrinsic discoloration.
There are techniques to reduce the effects of intrinsic staining, such as placing a bleaching agent inside the tooth following a root canal treatment. In some cases, the best approach may be to restore the tooth with a crown or porcelain veneer. The latter choice is a thin layer of dental material that is permanently bonded to the outer, visible portion of the tooth: it’s life-like color and appearance covers the discoloration, effectively renewing the person’s smile.
If you’ve been embarrassed by stained teeth, visit us for a complete examination. We’ll recommend the right course of action to turn your dull smile into a bright, attractive one.
If you would like more information on treatments for teeth staining, 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 “Teeth Whitening.”
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