Posts for category: Oral Health
Chronic pain and reduced function of the jaw joints, muscles and other surrounding tissues is generally known as a temporo-mandibular joint disorder (TMJD or TMD). It’s also possible that sufferers of TMD may also experience chronic pain in other parts of the body.
TMD affects from 10 million to 36 million American adults, mostly women of childbearing age. Although the exact causes are still elusive, most researchers believe this family of conditions arises from a combination of gender, genetic, environmental and behavioral factors. This may also hold the key to its connection with other painful conditions in the body.
About two-thirds of patients with some form of chronic jaw pain or disability also suffer from three or more similar medical conditions, including fibromyalgia, chronic fatigue syndrome, rheumatoid arthritis, headaches or sleep disturbances. Investigating the connections between these conditions is a fertile area for developing treatment strategies that would benefit all of these associated conditions.
In the meantime, there are both thermal and surgical treatments for alleviating and managing pain associated with TMD. About 90% of TMD patients respond well to thermal treatments, including hot and cold compresses applied to the jaw area and hot baths. Surgical treatment, however, has a mixed result: some studies show only a third of those undergoing surgical procedures experience noticeable pain relief and restored function and nearly half indicate worse symptoms after the surgery.
The best approach is to begin with an examination by your primary physician or specialist to be sure you are not suffering from a medical condition mimicking the symptoms of TMD. If this should eventually lead to a diagnosis of TMD, you should first try thermal techniques with over-the-counter pain relievers to ease the symptoms. A diet with softer foods that don’t require strenuous chewing may also prove helpful.
If you receive a recommendation for extensive bite treatment or surgery, you should discuss this thoroughly with your dentist, or even seek a second opinion. Surgical treatments in particular are not reversible and the results may not be favorable.
For more information on TMD and networking opportunities with other patients, be sure to visit the TMJ Association (www.tmj.org) on the Web.
If you would like more information on 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 “Chronic Jaw Pain and Associated Conditions.”
Nearly everyone who has ever played a sport, or had a child participate in one, has had that panic-filled moment when they witness an injury. And when you consider that there are more than 22,000 dental injuries each year in children younger than 18 years of age, you see there is fact to backup this concern. This is just one reason why we strongly encourage all of our patients who are involved in activities such as football, soccer, hockey, wrestling, lacrosse, skateboarding, field hockey and more to wear one of our custom-fitted professional mouthguards. It is especially true for basketball and baseball, which are responsible for the largest number of dental injuries.
The following are some key issues to help you understand the importance and advantages mouthguards offer.
Is there a way to determine who is at the highest risk for sports injuries?
Yes there are several. Age, gender, dental anatomy, and the type of sports being played are the four categories used to measure the risks for dental injuries. Young male teens still top the list of most likely to be injured; however, the gap is closing with more females getting involved in sports. Learn which sports or exercise activities made the American Dental AssociationÃ¢Â€Â™s list of recommendations for using a custom mouthguard, when you continue reading “Athletic Mouthguards.”
What's the difference between a “boil and bite” mouthguard and a professionally made mouthguard?
We are often asked this very important question. While some over-the-counter (OTC) mouthguards provide what is advertised as a “custom-fit” to your teeth, it is nowhere near the fit — and thus protection — you receive from our mouthguards that are crafted from precise molds of your teeth. Additionally, because all aspects of our mouthguards are tailored to each specific mouth, they provide much more protection and comfort. This important fact can enhance performance as the athlete can literally breathe easier while wearing one of our mouthguards.
What can I do if I witness a dental injury?
The first important fact to know is that you do not have to be a dental or healthcare professional to assist. However, before jumping in to help out, consult Dear Doctor's Field-Side Guide to Dental Injuries. This pocket-sized, quick-reference guide details what you should do at the scene of a dental injury based on the type of injury. But best of all, it is available to you free of charge from Dear Doctor.
Want to know more?
Nightly snoring can be a sign of a dangerous condition called sleep apnea (from “a” meaning without and “pnea” meaning breath). When someone snores the soft tissues in the back of the throat collapse onto themselves and obstruct the airway, causing the vibration known as snoring.
If the obstruction becomes serious, it is called obstructive sleep apnea, or OSA. In such cases the flow of air may be stopped for brief periods, causing the person to wake for a second or two with a loud gasp as he attempts to catch his breath. This can cause heart and blood pressure problems, related to low oxygen levels in the blood. The obstruction and mini-awakening cycle can occur as many as 50 times an hour. A person with this condition awakens tired and faces the risk of accidents at work or while driving due to fatigue.
Studies show that sleep apnea patients are much more likely to suffer from heart attack, congestive heart failure, high blood pressure, brain damage and strokes.
What can be done to treat OSA?
Snoring, apnea, and OSA occur more frequently in people who are overweight. So start with losing weight and exercising.
At our office, we can design oral appliances to wear while sleeping that will keep your airway open while you sleep. These appliances, which look like sports mouth guards, work by repositioning the lower jaw, tongue, soft palate and uvula (soft tissues in the back of the throat); stabilizing the lower jaw and tongue; and increasing the muscle tone of the tongue.
Another approach is to use a Continuous Positive Airway Pressure (CPAP) bedside machine. These machines send pressurized air through a tube connected to a mask covering the nose and sometimes the mouth. The pressurized air opens the airway so that breathing is not interrupted.
Much less frequently, jaw surgeries may be recommended to remove excess tissues in the throat. These would be done by specially trained oral surgeons or ear, nose and throat specialists.
Diagnosis and treatment of OSA is best accomplished by joint consultation with your physician and our office. Contact us today to schedule an appointment to discuss snoring and OSA. You can learn more by reading the Dear Doctor magazine articles “Sleep Disorders and Dentistry” and “Snoring and Sleep Apnea.”
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.”