Posts for: April, 2013
If you have pain in your jaws or related headaches, you may have Temporo-mandibular Joint Disorder, TMD. You are probably wondering what this is — and how it can be treated. If this sounds like something you may have, read on for some answers.
What is TMD? TMD describes a group of disorders or diseases that have the same symptoms, but may have different causes, hence it is known as “The Great Imposter.” Pain in and around the temporo-mandibular joint (TMJ), the jaw joint involved in opening and closing your mouth — is characterized by pain and soreness in the region of one or both joints, ears, jaw muscles and even the sinuses.
How does the temporo-mandibular joint work? You can feel your jaw joints working if you place your fingers in front of your ears and move your lower jaw up and down. On each side the joint is composed of an almond shaped structure at the end of the lower jaw, called the condyle, which fits neatly into a depression in the temporal bone (the bone on the side of your skull near your ear). A small disc between the two bones allows the lower jaw to move forward and sideways. The joints are stabilized by ligaments and moved by muscles, like all your joints.
What is the most common cause of TMD? Many people clench or grind their teeth as a reaction to stress. This is generally a subconscious habit, and can even occur during sleep. Continual tooth grinding habits can cause the muscles to go into spasm, which is the most common cause of TMD pain. Structures associated with the jaws — teeth, air sinuses, and even neck and back muscles — share nerves with the muscles in the joints, so the pain may be felt in those structures too, making the exact source of the pain difficult to diagnose. Symptoms of TMD may limit your ability to open your jaw and talk or eat normally.
What is the treatment for TMD? Treatment will depend on the cause, but generally the first step is to relieve pain and discomfort with heat, mild painkillers, muscle relaxants, a soft diet, and simple jaw exercises. A bite guard may be recommended, which should be custom made in our office; a rigid yet unobtrusive plastic appliance that fits over the biting surfaces of your upper teeth. Properly fitted and adjusted, it aids and causes jaw muscle relaxation by preventing clenching and grinding. It is worn during times of stress when oral habits tend to recur, and can also be worn at night.
If you are suffering from TMD — whether the pain is moderate or severe — schedule an appointment with us to have it evaluated and treated. You can learn more about TMD by reading the Dear Doctor magazine article “TMD: Understanding the Great Imposter.”
Do you clench your jaw or grind your teeth? Bite your nails? Chew on pencils or toothpicks? Or, heaven forbid, unscrew hard-to-open bottle caps using your precious pearly whites?
Over time, habits such as these — referred to in dentistry as “parafunctional” (para – outside; functional – normal) or beyond the range of what nature intended — can inflict excessive wear and tear on your teeth. Besides the impact damaged teeth can have on your smile, so called “tooth to tooth” and “tooth to foreign object” behaviors can cause physical problems, such as jaw joint and muscle pain, headaches, earaches, and even neck and back pain.
Use of Excessive Force
Parafunctional behaviors exert an abnormal amount of force on your teeth — up to 10 times the amount used for biting and chewing. Tooth grinding or “bruxism” (from the Greek word brykein – “gnash the teeth”) is particularly detrimental and is commonly seen in individuals who are experiencing a stressful time in their life. Some medications can also trigger it. Since bruxism often occurs while people sleep, it's possible to be unaware of it unless a partner comments (it can be noisy!) or a dental professional points out the tell-tale signs of wear.
To counter the adverse effects of nocturnal tooth grinding our office can create a customized night or occlusal (bite) guard. Typically fashioned from a hard, clear “processed acrylic” (wear-resistant plastic), this type of guard is amazingly inconspicuous. It is made to fit over the biting surfaces of the upper teeth only and is thinner than a dime. When it is worn, the lower teeth easily glide over the upper teeth rather than chomping into and gnashing with them, which minimizes the likelihood of erosion, chipping and uneven or excessive wear of the biting surface of the teeth. The guard is so unobtrusive, that some people even wear it as they go about their daily activities.
Remember: In addition to proper dental hygiene, you can help keep your teeth healthy by using them wisely!
If you would like more information about parafunctional habits like bruxism and ways to protect your teeth, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Stress & Tooth Habits” and “How And Why Teeth Wear.”
If you think you'd rather wrestle a pack of porcupines than go to the dentist for a root canal treatment — then maybe it's time to think again! This common procedure has been the butt of jokes for a long time. Let's set the record straight by answering some common questions about the much-maligned procedure.
Q: What is a root canal?
A: Coursing through the central part of each root is a hollow space or canal, which contains the pulp tissue. The pulp tissue contains the nerves which respond to temperature changes transmitted through the tooth. When the temperatures are extreme the nerves signal sensitivity and pain. It's also shorthand for the dental procedure that is performed when the pulp tissue that fills these canals develops a disease.
Q: Why do I need to get a root canal?
A: Because an infection or inflammation has developed deep inside one or more of your teeth. When the living pulp tissue — which contains nerves and blood vessels — becomes inflamed or infected, it can cause intense pain. It also releases bacterial toxins, which can lead to further problems.
Q: What happens if I don't get a root canal?
A: Your acute pain may temporarily go away, but the infection won't. It will eventually travel through the tooth's roots into the surrounding tissues. If left untreated, it may result in an abscess or even a systemic infection. That's why you need to take care of it now.
Q: Will it be painful?
A: Generally, a root canal procedure is no more painful than getting a filling. In fact, it starts the same way: An anesthetic is given to numb the tooth and the surrounding area. Then a small hole is made through the tooth's chewing surface and down into the canal. Diseased pulp tissue is removed through the hole via a set of tiny instruments. Finally, the root canal is cleaned, disinfected, filled with inert biocompatible material and sealed up.
Q: What happens after that?
A: Your tooth may be sensitive for a few days after the treatment, but the acute pain will be gone. Over-the-counter pain relievers generally work well for pain relief at this point. To restore your tooth to its fully-functioning state, a crown or other restoration is usually needed after root canal treatment. Properly done, the restored tooth can last as long as any of your natural teeth.
Q: Is there an alternative?
A: Yes. You can relieve the pain by having the tooth removed. But you don't want to go there. Tooth loss can lead to unwanted side effects, like migration of teeth, bone loss and eventually the inability to chew properly. It's far better to save your natural teeth when you can.
If you would like more information about root canals, please contact us to schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Common Concerns About Root Canal Treatment” and “Signs and Symptoms of a Future Root Canal.”
Dental implants are now the gold standard for tooth replacement. Why? Because not only do they offer the longest-lasting method of restoring missing teeth, but they also help mitigate one of the greatest problems associated with tooth loss — the loss of underlying bone structure. While standard dental implants have been around since the 1970s, mini-implants are a smaller version of the same technology that have recently come into their own. Here are a few things you should know about them.
Mini-implants rely on the same structure and principles as their larger relatives.
Like standard implants, mini-implants are screw-shaped devices made of titanium which are set into the bone of the jaw. Put in place permanently, they become fixed to the bone itself, which grows around and fuses to the implant. Or, they can be used as temporary anchors for the attachment of other dental work.
Mini-implants are a great option for attaching lower overdentures.
Overdentures (implant-retained dentures) are now considered the standard of care for people who have lost all of their teeth in one or both jaws. But the undesired movement of lower dentures has been a perennial problem for many denture wearers. One key use of mini-implants is to anchor overdentures to the lower jaw. Just two mini-implants provide the stability needed to attach a set of lower dentures sturdily, giving the denture wearer increased dental function — and a restored sense of confidence.
Mini-implants offer some real benefits in orthodontics.
TADS (Temporary Anchorage Devices), another type of mini-implants, are finding increasing use alongside of orthodontic appliances (braces). Braces move teeth by placing small forces on them, which are transmitted by a wire. The wire must be anchored at a “fixed” point: usually, other teeth; but it may cause these teeth to move as well! TADS offer an anchorage point that's truly immovable. They help to speed up orthodontic treatment, and give more accurate control as well.
Placing mini-implants is a relatively simple process.
It's an office procedure done by an experienced clinician, normally under local anesthesia. Most patients tolerate the procedure very well, experiencing only minor discomfort. In some cases, a single two-hour visit is all that's needed for implant placement, and the patient can go home and eat a steak afterward!
Mini-implants may be more economical than you think.
These smaller cousins of standard implants are often easier to place. They save treatment time, and, if you're a denture wearer, they may be compatible with your existing dentures. If your dental situation could benefit from using mini-implants, you should give them serious consideration.
If you would like more information about mini-implants, please contact us or schedule an appointment for a consultation. You can also learn more about this topic by reading the Dear Doctor magazine articles “Implant Overdentures for the Lower Jaw,” “The Great Mini-Implant,” and “What are TADS?”