If you have chronic jaw pain, you know how difficult eating, speaking or even smiling can be. Many sufferers will do anything to gain relief, even surgery. But before you go down that road, consider the traditional conservative approach to temporomandibular disorders (TMD) management first—it could provide the most relief with the least risk of side effects.
The temporomandibular joints connect the lower jaw to the skull on either side of the head. These ball and socket joints also contain a cushioning disk to facilitate movement. This disk is believed to be the primary focus for jaw pain problems known collectively as TMD.
Doctors now believe injury, stress, metabolic issues, jaw anatomy defects or similar factors trigger the chain reaction of muscle spasms, pain and soreness that can erupt during a TMD episode. A TMD patient may experience pain within the jaw muscles or joints themselves, clicking sensations, or an inability to open the jaw to its full range.
TMD therapy has traditionally followed an orthopedic path—treating jaw joints like any other joint. In recent years, though, a more aggressive treatment model has emerged that promotes more invasive techniques like orthodontics, dental work or jaw surgery to relieve discomfort. But the track record for this model, especially concerning jaw surgery, remains hazy at best and offers no guarantee of relief. These techniques are also irreversible and have even made symptoms worse in some patients.
It’s usually prudent, then, to try conservative treatments first. This can include pain and muscle relaxant medication, jaw exercises, stretching and massage, and dietary changes to reduce chewing force. Patients with teeth grinding habits may also benefit from a bite guard worn at night to reduce the biting force during sleep and help the joints relax.
By finding the right mix of treatments, you may be able to find significant relief from TMD symptoms with the conservative approach. If not, you might then discuss more invasive options with your dentist. But even if your dentist recommends such a procedure, you would be wise to seek a second opinion.
TMD can definitely interfere with your quality of life and peace of mind. But there are ways to reduce its effects and make for a happier life.
If you would like more information on managing chronic jaw pain, 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.”
While most tooth loss stems from dental disease or injury, another major cause is a condition known as cracked tooth syndrome. What begins as a microscopic crack in an individual tooth’s enamel could ultimately grow to a fracture that endangers its survival.
Most often related to age-related brittleness, expansion and contraction of the enamel surface because of hot foods followed by cold foods and beverages, or grinding habits, cracked tooth syndrome usually occurs in three phases. The first phase is the emergence of miniscule cracks in the outer enamel known as craze lines. These can be very difficult to detect even with x-rays, and usually calls for specialized detection methods such as probing with a sharp instrument (an explorer) or fiber-optic lighting with dye staining to highlight enamel abnormalities. If you have pain symptoms, we may ask you to bite down on a bite stick or rubber pad to locate the area by replicating the sensation.
In the next phase, the craze line grows into a crack that penetrates below the enamel into the tooth’s dentin. Pain becomes more prominent and the risk of infection increases. Left untreated, the crack may enter the third phase, a full break (fracture) occurring deep within the inner layers of the tooth. The deeper the fracture occurs, the more serious the danger to the tooth, especially if the pulp is exposed.
The best treatment approach is to attempt to detect and treat a crack as early as possible. Craze lines and moderate cracks can usually be repaired with restorative materials like composite resins. A deeper crack extending into the pulp may require a root canal treatment and the tooth covered with a permanent, protective crown.
If, however, the fracture is too deep, the tooth may be beyond repair and will need to be extracted and replaced with a dental implant or permanent bridge. In any event, the sooner a cracked tooth is discovered and treated, the greater your chance of avoiding pain, discomfort, and, ultimately, tooth loss.
If you would like more information on cracked tooth syndrome, 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 “Cracked Tooth Syndrome.”
As your mother used to say, “A moist mouth is a healthy mouth.” Well, maybe she didn't — but it's still true. Without the constant flow of saliva, your teeth and gums would be less healthy.
That's because among its many functions, saliva helps keep the mouth from becoming too acidic. Just after eating, your mouth's neutral pH level tips to the acidic side of the scale. Acid is enamel's number one enemy, and it takes little time for it to begin dissolving mineral content. But in thirty minutes to an hour, saliva neutralizes the acid; it also helps restore some of the enamel's minerals.
Without adequate saliva flow, acid quickly gets the upper hand. In time, this can greatly increase your risk for dental disease. And for many people, inadequate saliva — dry mouth — is a chronic problem.
There are a number of reasons why. Salivary glands may not produce as much in our later years. In addition, as we age, we may begin taking more medications, some of which can cause dry mouth. Treatments for certain kinds of systemic diseases, particularly cancer, can also inhibit saliva or even damage salivary glands.
If you feel your mouth is continuously dry, make an appointment to find out the cause, which will determine the best course of action to alleviate it. If it's related to your medication, we'll see if there's an alternative. If not, you may need to drink more water when you take your medication and more throughout the day.
There are other things you can do as well. Reduce your intake of acidic foods or caffeinated beverages. Run a cool-air humidifier at night to keep your mouth and nose membranes moist. And you can also try saliva stimulants available by prescription or even over the counter. Chewing gum with xylitol (an alcohol-based sugar) has also been shown to stimulate saliva flow.
Above all, be diligent about daily brushing and flossing and regular dental cleanings and checkups. Keeping a watchful eye will help ensure dental disease doesn't take advantage of your dry mouth.
If you would like more information on managing dry mouth, 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 “Dry Mouth.”
Is a chipped tooth big news? It is if you’re Justin Bieber. When the pop singer recently posted a picture from the dental office to his instagram account, it got over 2.6 million “likes.” The snapshot shows him reclining in the chair, making peace signs with his hands as he opens wide; meanwhile, his dentist is busy working on his smile. The caption reads: “I chipped my tooth.”
Bieber may have a few more social media followers than the average person, but his dental problem is not unique. Sports injuries, mishaps at home, playground accidents and auto collisions are among the more common causes of dental trauma.
Some dental problems need to be treated as soon as possible, while others can wait a few days. Do you know which is which? Here are some basic guidelines:
A tooth that’s knocked out needs attention right away. First, try and locate the missing tooth and gently clean it with water — but avoid holding the tooth’s roots. Next, grasp the crown of the tooth and place it back in the socket facing the correct way. If that isn’t possible, place it between the cheek and gum, in a plastic bag with the patient’s saliva or a special tooth preservative, or in a glass of cold milk. Then rush to the dental office or emergency room right away. For the best chance of saving the tooth, it should be treated within five minutes.
If a tooth is loosened or displaced (pushed sideways, deeper into or out of its socket), it’s best to seek dental treatment within 6 hours. A complete examination will be needed to find out exactly what’s wrong and how best to treat it. Loosened or displaced teeth may be splinted to give them stability while they heal. In some situations, a root canal may be necessary to save the tooth.
Broken or fractured (cracked) teeth should receive treatment within 12 hours. If the injury extends into the tooth’s inner pulp tissue, root canal treatment will be needed. Depending on the severity of the injury, the tooth may need a crown (cap) to restore its function and appearance. If pieces of the tooth have been recovered, bring them with you to the office.
Chipped teeth are among the most common dental injuries, and can generally be restored successfully. Minor chips or rough edges can be polished off with a dental instrument. Teeth with slightly larger chips can often be restored via cosmetic bonding with tooth-colored resins. When more of the tooth structure is missing, the best solution may be porcelain veneers or crowns. These procedures can generally be accomplished at a scheduled office visit. However, if the tooth is painful, sensitive to heat or cold or producing other symptoms, don’t wait for an appointment — seek help right away.
Justin Bieber earned lots of “likes” by sharing a picture from the dental office. But maybe the take-home from his post is this: If you have a dental injury, be sure to get treatment when it’s needed. The ability to restore a damaged smile is one of the best things about modern dentistry.
If you have questions about dental injury, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Repairing Chipped Teeth” and “Porcelain Crowns & Veneers.”
Getting a smile upgrade doesn’t necessarily require extensive dental work. You might be able to change your appearance for the better with teeth whitening.
This technique employs a bleaching solution that brightens dull enamel, the outermost layer of teeth. It isn’t a permanent fix, but if cared for properly your brighter smile could last two years or more.
Here’s what you need to know about this proven smile brightener.
Know your options. Enamel whitening is usually obtained in one of three ways: a dentist performing the procedure in-office; at home using custom trays created by a dentist; or at home with an over-the-counter whitening product. The in-office option is the most expensive—but since dentists use a stronger bleaching solution, your brighter tint may last longer and dentists can control the degree of whiteness better.
Know your preferences. That last point is important if you’re looking for a particular look. Teeth whitening can give you a dazzling “Hollywood” smile or one that’s a bit more subtle. It all depends on your lifestyle and personal preferences. Because of their advanced techniques and equipment, you may have better chances getting the look you want from your dentist rather than by doing it yourself.
Know your limitations. This type of teeth whitening won’t work if the staining originates within the teeth—for that you’ll need an invasive procedure only a dentist can perform. You’ll also want to be careful with any whitening if you have dental work like crowns, veneers or fillings: the bleaching solution won’t alter these materials’ color, which could make them stand out beside whitened natural teeth. And if you have diseased teeth and gums, those need to be treated first before any cosmetic procedures like whitening.
Teeth whitening is a great way to take years off a smile. Even if you plan to whiten your teeth at home see your dentist first for a complete examination and helpful tips on products and techniques.
If you would like more information on teeth whitening, 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 “Important Teeth Whitening Question…Answered!”
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