Posts for category: Oral Health
Tenderness; headaches; difficulty chewing; excruciating pain. These are a few of the symptoms you could endure with a jaw joint or temporomandibular disorder (TMD or TMJ). This group of disorders disrupts the daily lives of millions of people around the world.
This month is TMJ Awareness Month, to shed light on these debilitating conditions and how best to manage them. Although controlling TMD isn't always easy, it can be done with the right blend of treatments.
The temporomandibular joint—actually a pair of joints connecting the lower jaw to the skull on either side of the face—is "ground zero" for TMD. These are ball-and-socket joints similar to the hip or shoulder, but with a unique addition—a cushioning disk that lies between the adjoining points of the two bones that temper the forces generated when you eat, speak or bite down.
Researchers believe TMD can arise from a variety of sources, including traumatic injury, psychological stress or mechanical dysfunction within the joint and cushioning disk. These problems can create blood flow constriction, which in turn causes the accumulation of chemical waste byproducts in the jaw muscles. This in turn and cause the muscles to spasm and become inflamed and sore.
Treatments are also as numerous as the possible causes of TMD. But for the most part, they range along a continuum of conservative to aggressive approaches.
On the conservative end, doctors treat TMD as a joint problem and borrow heavily from orthopedics. These types of treatments include the use of anti-inflammatory and muscle relaxing medications, icing or heating, stretching exercises, physical therapy and massage. Dentists may also provide mouth guard appliances for patients with clenching or tooth grinding habits to decrease biting forces.
On the more aggressive end are interventions like orthodontics or dental work. But, while these were common recommendations 20-30 years ago, it's no longer thought to be necessary for treating most TMD disorders and should not be recommended as a cure or solution for TMD. At the furthest extreme is actual jaw surgery to relieve symptoms or repair damage within the joints. The latter, however, has not yet amassed a solid track record, and should be considered as a last resort.
Finding the right combination of therapies to give consistent relief sometimes requires a bit of trial and error. Most doctors recommend starting first with the most conservative methods before considering more aggressive measures. You should also undergo a complete dental exam to see if teeth or gum problems are contributing to your symptoms.
TMD can make your life miserable. But with some persistence and patience, you can find what works for a life without pain and dysfunction.
Although there are several potential problems people could encounter involving their teeth, gums or mouth, most fall into three basic categories. That's the finding of a recent survey conducted by the American Dental Association of more than 15,000 U.S. adults.
These categories are a triad of symptoms, each of which could arise from a variety of causes. If you're encountering any one of these, you should see your dentist as soon as possible.
Tooth pain. A toothache—or any form of pain from the mouth—could be sign of a number of possible issues. It could mean you have a decayed tooth, especially if the pain is sharp and localized. It could also indicate a gum abscess (accompanied by red and puffy gums), a sinus or ear infection, or inflammation of the jaw joints. The intensity, duration and location of the pain are all clues to its actual cause and what treatments it might require.
Biting difficulties. Does it hurt when you bite down? Among other things, you could have a loose tooth or one that's deeply decayed. The former could be the sign of advanced gum disease, which itself must be treated and the tooth stabilized (splinted) to other teeth. If the problem is advanced decay, you may need a root canal to remove diseased tissue from within the interior of the tooth, which is then filled and crowned to prevent re-infection.
Dry mouth. We're not talking about that "cotton mouth" feeling we all get now and then. This is a chronic condition known as xerostomia in which the mouth feels dry all the time. Xerostomia has several causes including smoking or treatments for cancer or other serious diseases. It might also be a medication you're taking, which has reduced your mouth's saliva production. Because dry mouth could lead to dental disease, you should take steps to relieve it.
Even if you're not having symptoms like these, there may still be something going on in your mouth that needs attention. That's why you should see your dentist on a regular basis, besides when you notice a problem, to keep your oral health in tip-top shape.
October 20th is World Osteoporosis Day, putting the spotlight on this degenerative bone condition and the impact it has on millions of people. Not only does it significantly increase the risk of potentially life-threatening fractures, but it can also indirectly affect dental health.
This connection arises from the use of certain treatment drugs that ultimately could lead to complications following some forms of dental work. These particular drugs, mainly bisphosphonates like Fosamax™ and RANKL inhibitors like Prolia™, destroy bone cells called osteoclasts, whose function is to clear away worn out regular bone cells (osteoblasts). With fewer osteoclasts targeting them, more older osteoblast cells survive longer.
In the short-term, a longer life for these older cells helps bones afflicted by osteoporosis to retain volume and density, and are thus less likely to fracture. Long-term, however, the surviving osteoblasts are less elastic and more brittle than newly formed cells.
In the end, these longer living cells could eventually weaken the bone. In rare situations, this can result in parts of the bone actually dying—a condition known as osteonecrosis. The bones of the body with the highest occurrences of osteonecrosis are the femur (the upper leg bone) and, of specific concern to dental care, the jawbone.
The effect of these medications on the jawbone actually has a name—drug-induced osteonecrosis of the jaw (DIONJ). Fortunately, there's only a 1% risk of it occurring if you're taking these drugs to manage osteoporosis. It's also not a concern for routine procedures like cleanings, fillings or crown placements. But DIONJ could lead to complications with more invasive dental work like tooth extraction, implant placement or periodontal surgery.
It's important, then, that your dentist knows if you're being treated for osteoporosis and the specific drugs you're taking. Depending on the medication, they may suggest, in coordination with your physician, that you take a "drug holiday"—go off of the drug for a set period of time—before a scheduled dental procedure to ease the risk and effects of osteonecrosis.
Because infection after dental work is one possible consequence of osteonecrosis, it's important that you practice thorough oral hygiene every day. Your dentist may also prescribe an antiseptic mouth rinse to include with your hygiene, as well as antibiotics.
You may also want to talk to your doctor about alternative treatments for osteoporosis that pose a lower risk for osteonecrosis. These can range from traditional Vitamin D and calcium supplements to emerging treatments that utilize hormones.
Osteoporosis can complicate dental work, but it doesn't have to prevent you from getting the procedures you need. Working with both your dentist and your physician, you can have the procedures you need to maintain your dental health.
If you would like more information about osteoporosis and dental care, please contact us or schedule a consultation.
"Trick or treat!" Chances are, you'll hear that cry from costumed children at your door this October 31st. Fortunately, you're unlikely to be in any danger of mischief should you fail to reward your trick or treaters. But there may be an unpleasant "trick" awaiting them—or, more specifically, their teeth: tooth decay.
The underlying factor for this occurrence is the candy they've eagerly collected on their spooky foray, over $2 billion worth nationwide for this one holiday alone. That's because all that candy your kids will fill up on post-Halloween is loaded with refined sugar.
But something else loves all that sweetness as much as your kids—decay-causing bacteria living in their mouths. Oral bacteria thrive—and multiply—on sugar—which means more acid, a by-product of their digestive process, which can erode tooth enamel, which then opens the door to tooth decay.
Now, we don't want to rain on anyone's parade, much less on a child's traditional night of fun in late October. The key, like many other of life's pleasures, is moderation. Here, then, are a few tips from the American Dental Association for having a more "dental-friendly" Halloween.
Provide alternative treats. Candy may be ubiquitous to Halloween, but it isn't the only thing you have to put in their sacks. Be sure you also include items like sealed, one-serving packages of pretzels, or peanut butter or cheese sandwich crackers.
Choose candy wisely. Considering dental health, the best candies are those that don't linger in the mouth long. Stay away, then, from sticky or chewy candies, which do just that. Also, try to avoid hard candies that might damage the teeth if bitten down on.
Don't keep it all. Before they dig in, have your child sort through their sack and choose a set number of pieces to keep and enjoy. Then, find a creative way to share the rest with others. This limits the number of sugary treats consumed after Halloween, while also encouraging sharing.
Restrict snacking. Continuous snacking on Halloween candy can be a problem—the constant presence of sugar in the mouth encourages bacterial growth. Instead, limit your child's snacking on Halloween treats to select times, preferably after meals when saliva (an acid neutralizer) is more active.
Brush and floss. Even with non-sugary foods and snacks, dental plaque can still build up on teeth. This thin biofilm provides a haven for bacteria that increases your child's chances for tooth decay. Be sure, then, that your kids brush and floss every day, especially around holidays.
Halloween can be the source for fond, childhood memories. Follow these tips to make sure tooth decay doesn't ultimately put a damper on your family's fun.
If you would like more information about protecting your children's teeth from tooth decay, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “The Bitter Truth About Sugar.”
More than one parent has wakened in the middle of the night to an unnerving sound emanating from their child's bedroom. Although it might seem like something from the latest horror flick is romping around in there, all that racket has a down-to-earth cause: teeth grinding.
Teeth grinding is the involuntary habit of gnashing the teeth together when not engaged in normal functions like eating or speaking. It can occur at any time, but frequently with children while they sleep. Adults may also grind their teeth, but it's more prevalent among children.
While stress seems to be the main reason for adult teeth grinding, many health providers believe the habit in children is most often caused by an overreactive response of the neuromuscular system for chewing, which may be immature. Other conditions like asthma, sleep apnea or drug use may also play a role.
Fortunately, there doesn't appear to be any lasting harm from young children grinding their teeth, although they may encounter problems like headaches, earaches or jaw pain in the short term. Most, though, will outgrow the habit and be no worse for wear.
But if it persists beyond childhood, problems can escalate. Adults run the risk of serious cumulative issues like chronic jaw pain, accelerated tooth wear or tooth fracturing. It's similar to finger sucking, a nearly universal habit among young children that poses no real harm unless it persists later in life.
And as with finger sucking, parents should follow a similar strategy of carefully monitoring their child's teeth grinding. If the habit continues into later childhood or adolescence, or noticeable problems like those mentioned previously begin to appear, it may be time to intervene.
Such intervention may initially include diagnosis and treatment for underlying problems like upper airway obstruction, asthma or stress. For short term protection against dental damage, your dentist can also fashion a custom mouthguard for your child to wear while they sleep. Made of pliable plastic, the guard prevents the teeth from making solid contact with each other during a grinding episode.
Outside of some lost sleep, there's little cause for alarm if your child grinds their teeth. But if it seems to go on longer than it should, you can take action to protect their long-term dental health.
If you would like more information on teeth grinding, 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 “When Children Grind Their Teeth.”