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.
You know what people say: "Protect your tooth enamel, and it will protect your teeth." Then again, maybe you've never heard anyone say that—but it's still true. Super strong enamel protects teeth from oral threats that have the potential to do them in.
Unfortunately, holding the title of "Hardest substance in the human body" doesn't make enamel indestructible. It's especially threatened by oral acid, which can soften its mineral content and lead to erosion.
That doesn't have to happen. Here are 5 things you can do to protect your enamel—and your teeth.
Don't brush too often. Brushing is essential for removing bacterial plaque, the main cause for dental disease. But more isn't always good—brushing too frequently can wear down enamel (and damage your gums, too). So, limit daily brushing to no more than twice a day.
Don't brush too soon. Oral acid normally peaks at mealtime, which can put your enamel into a softer than normal state. No worries, though, because saliva neutralizes acid within about an hour. But brushing before saliva finishes rebuffering could cause tiny bits of softened enamel to flake off—so, wait an hour after eating to brush.
Stop eating—right before turning in for the night, that is. Because saliva flow drops significantly during sleep, the decreased saliva may struggle to buffer acid from that late night snack. To avoid this situation, end your eating or snacking at least an hour before bedtime.
Increase your calcium. This essential mineral that helps us maintain strong bones and teeth can also help our enamel remineralize faster after acid contact. Be sure, then, to include calcium-rich foods and calcium-fortified beverages in your diet.
Limit acidic beverages. Many sodas, sports and energy drinks are high in acid, which can skew your mouth's normal pH. Go with low-acidic beverages like milk or water, or limit acidic drinks to mealtimes when saliva flows more freely. Also, consider using a straw while drinking acidic beverages to lessen their contact with teeth.
Remember, enamel isn't a renewable resource—once it's gone, it's gone. Take care of your enamel, then, so it will continue to take care of you!
If you would like more information on caring for your tooth enamel, 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 “6 Tips to Help Prevent the Erosion of Tooth Enamel.”
British pole vaulter Harry Coppell had an unpleasant mishap right before the Tokyo Olympic games. During a training vault, Coppell glanced the top bar to loosen it, which then fell on top of his face on the mat. The impact broke one of his front teeth nearly in two and severely damaged others.
Coppell posted the accident on Instagram, along with a photo of the aftermath. "I hope @tokyo2020 has a good dentist around," he quipped in the caption. Alas, after several hours with a dentist, one of the injured teeth couldn't be saved, although the chipped tooth remained. Needless to say, the Olympian's smile took a beating along with his teeth.
Fortunately, through the marvels of cosmetic dentistry, Coppell can eventually regain his attractive smile. Still, though, his experience is a blunt reminder that sports and other physical activities do carry some risk for dental injury, especially for active young adults and children.
A chipped tooth is the most common outcome of a traumatic dental injury, but not the only one: you might also suffer from a displaced, loosened or even knocked-out tooth. And, even if the teeth don't appear injured after face trauma, there could be underlying gum and bone damage that requires prompt emergency care from a dentist.
Of course, preventing a dental injury is far better than treating one that has occurred—and wearing an athletic mouthguard is your best bet for dodging such a bullet. A mouthguard's soft plastic helps absorb the force of a hard impact so that the teeth and gums don't. This important protective gear is a must for anyone who plays sports like football or basketball, or enjoys physical activities like trail biking.
When it comes to mouthguards, you have two general categories from which to choose. The first is called a "boil and bite," often found online or in sporting goods stores. These usually come in general sizes that can be customized further by softening in hot water and then having the wearer bite down while it's soft (hence the name). This personalizes the guard to fit the individual wearer.
The other category is a custom mouthguard created by a dentist from an impression of the wearer's mouth. Because of this specialized fit, custom mouthguards aren't usually as bulky as boil and bites, and are typically more comfortable to wear.
The key point, though, is that a mouthguard can help you avoid a serious dental injury, regardless of which category you choose. It could mean the difference between a forgettable incident or dental damage that could impact your life for years to come.
If you would like more information about preventing and treating dental injuries, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “Athletic Mouthguards.”
Physical pain is unpleasant—but not knowing why you're hurting makes it worse. Thousands of people encounter such as experience when parts of their face suddenly and mysteriously erupt in pain.
Often, though, the mystery can be quickly solved—more than likely, it's a nerve disorder known as trigeminal neuralgia (TN). Typically seen in people over 50 (and in more women than men), TN is a chronic condition that produces brief episodes of acute, spasmodic pain.
The source of this pain is the trigeminal nerve, which courses down each side of the face. Each nerve consists of three distinct branches that serve the upper, middle and lower areas of the face and jaw.
Physicians usually find that a blood vessel has come in contact with the nerve at some point, and the resulting pressure has damaged the nerve's outer insulative layer (myelin sheath). This causes the nerve to become hypersensitive at the point of contact, overreacting in a sense to the slightest touch (even a wisp of wind) on the face and jaw.
TN isn't the only source of facial pain. It can also accompany other conditions like TMD, which is why it's important to undergo a diagnostic examination. If you are diagnosed with TN, there are a number of ways to manage it. The most conservative approach (and the one usually tried first) is the use of medications to block pain signals from the nerve to the brain or to lessen abnormal nerve firing.
If medication proves ineffective or there are other factors related to age and health, you may be a candidate for a surgical solution. In one such procedure, a surgeon inserts a thin needle into the affected nerve and selectively damages some of its fibers to prevent the transmission of pain signals. Another procedure relocates the impinging blood vessel, which then allows the nerve to heal.
These surgical methods are effective but they can cause side-effects in rare cases like numbness or hearing impairment. It's best then to discuss with your doctor which approach would be best for you and your life situation. Ultimately, though, there are ways to relieve you of this painful condition.
If you would like more information on treating facial 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 “Trigeminal Neuralgia.”
As summer wanes, thousands of high school grads will begin the new adventure called college. For many of these "freshmen," it will also be their first taste of true independence—mom and dad and the guidance they normally provide will be far away.
This is generally a good thing. But there are also consequences to making (or not making) your own choices that can have long-lasting effects, some of which may not be pleasant. For example, neglecting teeth and gum care could disrupt oral health (as well as overall health) for years or even decades to come.
As your newly minted college student sets off on their new academic journey, be sure that among the advice you give them are these 3 important dental care habits.
Brush and floss daily. It's important to stress that among the things of childhood to leave behind, oral hygiene isn't one of them. Dental disease is mainly caused by dental plaque, a thin bacterial film that accumulates on teeth. Removing plaque daily with brushing and flossing greatly reduces disease risk. It's a top priority, even with a hectic college schedule.
Eat "tooth-friendly." That hectic schedule may also tempt them to grab whatever food is quick and available. Unfortunately, such food isn't always the healthiest, especially for teeth and gums. Foods and snacks loaded with sugar are especially perilous to oral health—sugar feeds the bacteria that cause tooth decay and gum disease. Healthier food choices contribute to healthier teeth and gums.
Avoid bad habits. The exhilaration of new independence can lead to a flurry of bad habits, some of which could affect teeth and gum health. Using tobacco increases the risk of dental disease and oral cancer. Wearing lip piercings or tongue jewelry may cause tooth damage. And certain forms of unprotected sex raise the chances of viral infection and an increased risk of oral cancer.
College can be an exciting adventure. But there are pitfalls along the way, especially for oral health. Advising your college student to follow these tips will help ensure their teeth and gums stay healthy beyond graduation.
If you would like more information on ways to keep your student's teeth and gums healthy, 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 “10 Health Tips For College Students.”
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