Posts for category: Oral Health
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.”
Tooth decay (dental caries) is one of the world’s most common infectious diseases. Left untreated, it can lead to tooth loss. The best treatment strategy, of course, is to prevent it from occurring in the first place with a long-term approach that begins in early childhood and continues throughout our lifetime.
Here are some basic components for just such a prevention strategy.
Know your risk. We each don’t share the same level of risk for tooth decay, so it’s important to come to terms with any factors that raise your personal risk for the disease — your dental history, inadequate oral hygiene, absence of fluoride use, and lifestyle habits like smoking. Coming to terms with these and other factors — and altering those you can change — can lower your risk.
Reduce acid-producing bacteria in your mouth. Tooth decay usually arises from elevated acidic levels in the mouth caused by certain strains of oral bacteria. You can reduce these bacteria by removing plaque, a thin film of food particles that collect on tooth surfaces, with daily oral hygiene and regular cleanings in our office. In some cases, we may also recommend antibacterial mouthrinses like chlorhexidine to further lower the bacterial population.
Apply protective measures to teeth. Fluoride, a naturally occurring chemical, has been proven effective in strengthening tooth enamel and reducing tooth decay. In addition to fluoride found in many oral hygiene products and public water systems, children can also benefit from a direct application of fluoride to the enamel surface just after the teeth have erupted in the mouth. Many clinical studies have shown 99% cavity free results in over a thousand teeth receiving a fluoride application with sealants.
Control your diet. Bacteria ferment leftover sugars and other carbohydrates in the mouth; this creates acid, which can soften tooth enamel and lead to decay. You can limit this effect by eating more fresh fruits and vegetables and reducing your consumption of refined sugar. You should also limit between meal snacking — constant snacking prevents saliva, the mouth’s natural acid neutralizer, from effectively restoring the mouth’s pH balance.
A prevention strategy for tooth decay will help you avoid unnecessary pain and problems — physically and financially. You’ll also reap the rewards that come from a lifetime of good dental health.
If you would like more information on preventing tooth decay, 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 “Tooth Decay.”
“We all scream for ice cream,” the saying goes. But what if eating ice cream — or any very cold or hot food — literally makes you want to scream because your teeth hurt so much?
What causes sensitivity in teeth?
Understanding the anatomy of a tooth helps explain what happens when a tooth becomes sensitive to heat and cold. A tooth is composed of three types of tissue: a hard outer shell of enamel, the body of the tooth composed of the dentin, and an interior tissue of the pulp.
Enamel: The enamel forms the outside of the crown, the part of the tooth you normally see. Made of densely packed crystals of calcium, it is resistant to wear. It is not living tissue, and does not contain nerves, but it is capable of transmitting temperature like hot and cold.
Dentin: Inside the tooth's crown and root is a living tissue called dentin, which is a porous structure similar to bone. It is composed of microscopic tubules containing living cells, which are encased in a hard substance made of calcium crystals.
Pulp: The living dentin transmits sensation through to the pulp, which is in the center of the tooth and contains the tooth's blood vessels and nerves.
A tooth's enamel normally protects the dentin from exposure to extremes of temperature and pressure. If you wear away the enamel and expose the dentin, it will pass sensation through to the nerves in the pulp more directly. The result can range from a twinge to an excruciating pain.
Sensitivity can be caused by:
- Overzealous tooth brushing resulting in enamel wear and consequently dentin exposure and wear.
- Enamel and dentin erosion by acids in the foods and beverages you eat and drink.
- Tooth decay — the most common cause of sensitivity. Decay destroys enamel and dentin inflaming and infecting the living tissues of the pulp, which become increasingly painful.
What can you do to make your teeth less sensitive?
- Use a soft bristle tooth brush, and brush the affected teeth gently to remove all bacterial plaque. We can advise you on safe and effective brushing techniques.
- Use toothpaste that contains fluoride. Fluoride strengthens tooth surfaces and makes them more resistant to sensitivity and decay.
- Ask us about professionally applied fluoride varnishes or filling materials that can cover and replace sensitive or lost tooth structure.
Of course, if the problem is caused by tooth decay, make an appointment with us to remove the decay and place a filling in the sensitive teeth.
Bacteria are bad… right? They can cause diseases like pneumonia, strep throat, and tooth decay. They are the reason we wash our hands with soap (or antibacterial gels) and cook (or refrigerate) our food. Yet it turns out that bacteria are also necessary to keep our bodies healthy — and new research is showing just how important these tiny microorganisms are to our well-being. Here are five facts you should know about bacteria.
The bacteria in our bodies outnumber our cells by a factor of 10 to 1. An estimated 100 trillion bacteria live inside the average human — but because they’re so small, they make up only 1-3 percent of our body mass.
The collection of bacteria we harbor is called our “microbiome.” Like the groundbreaking study of human DNA called the Human Genome Project, recent research is leading to a “map” of our bacterial makeup. This revolutionary study is called — you guessed it — the Human Microbiome Project.
No two people have exactly the same microbiome. But in general, the bacteria that live in a particular spot on the body (the mouth, for example) play the same roles in different individuals. Research has also shown that a healthy microbiome looks very different from a diseased microbiome.
In terms of bacteria, the mouth is one of the best-understood areas of the body. It has long been known that tooth decay can result when “bad” oral bacteria begin to outnumber their “good” counterparts. Now we are gaining a better understanding of how certain lifestyle factors — like cigarette smoking — may influence the bacterial balance in the mouth.
Understanding the microbiome may lead to new treatments for disease. Researchers hope that one day, certain serious diseases could be controlled by bacterial “transplants” that re-balance an individual’s microbiome. Maintaining a healthy microbiome could also help prevent many diseases.
So by all means, don’t stop brushing your teeth or washing your hands — this helps control bacteria that could harm you — but do remember that not all bacteria are harmful. One day, an infusion of bacteria might just cure your illness.
Tooth decay (also known as caries by professionals and as cavities by consumers) is an infectious disease process that damages tooth structure. Cavities, hollowed-out holes in the teeth, are the most common result of untreated caries. It affects millions of Americans, young and old alike.
How does this destructive process happen? It begins when acid-producing bacteria multiply beyond normal levels in the mouth. Dental plaque, a film of remnant food particles and bacteria, cover the teeth due to poor oral hygiene. The bacteria break down sugars and carbohydrates present in the mouth, which in turn produces acid. Too many “bad bacteria” can raise the acidic level in the mouth.
The normal pH level of the mouth is neutral — 7 on the pH scale. But when the acidic level increases, dropping the pH to 5.5, the calcium and phosphate minerals in the hard, protective layer of tooth enamel begin to dissolve in a process known as de-mineralization. A healthy flow of saliva, however, acts as a buffering agent to return the pH level of the mouth back to neutral. Saliva also contains calcium and phosphate that can replace those lost from the enamel and is referred to as re-mineralization.
So, a constant battle rages within the mouth. On one side acid-producing bacteria, the possible absence of saliva, and poor diet and hygiene habits create the conditions where teeth enamel loses its mineral strength, allowing decay to eventually invade the fragile inner dentin of the tooth; on the other side is an adequate flow of saliva, a good diet and hygiene, boosted by treatment options like sealant application, antimicrobials and the topical application of fluoride.
The key, of course, is prevention. We add protection to the teeth by strengthening them; applying fluoride topically is the best approach, along with sealants that can be applied in our office. We reduce the level of acid-producing bacteria, usually with an anti-bacterial mouth rinse. You can also adopt a healthier diet that limits sugars and carbohydrates and reduces snacking between meals.
These preventive measures, along with early treatment of known tooth decay, can help you avoid the full impact of this destructive disease.
If you would like more information on tooth decay and how to prevent it, 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 “Tooth Decay.”