Posts for: August, 2021
There's still much about the underlying nature of chronic jaw joint dysfunction we have yet to unravel. Treating these conditions known as temporomandibular joint disorders (TMDs) may therefore require some experimentation to find what works for each individual patient.
Most TMD therapies are relatively conservative: eating softer foods, taking anti-inflammatory pain relievers or undergoing physical therapy. There have been some surgical techniques tried to relieve jaw pain and dysfunction, but these have so far had mixed results.
Recently, the use of the drug Botox has been promoted for relieving jaw pain, albeit temporarily. Botox contains tiny amounts of botulinum toxin type A, a poisonous substance derived from the bacterium Clostridium botulinum, which can cause muscle paralysis. It's mainly used to cosmetically smooth out small wrinkles around facial features.
Because of these properties, some physicians have proposed Botox for TMD treatment to paralyze the muscles around the jaw to reduce pain and discomfort. While the treatment sounds intriguing, there are a number of reasons to be wary of it if you have TMD.
To begin with, the claims for Botox's success in relieving jaw pain have been mainly anecdotal. On the other hand, findings from randomized, double-blind trials have yet to show any solid evidence that Botox can produce these pain-relieving effects.
But even if it lived up to the claims of TMD pain relief, the effect would eventually fade in a few weeks or months, requiring the patient to repeat the injections. It's possible with multiple Botox injections that the body will develop antibodies to fight the botulinum toxin, causing the treatment to be less effective with subsequent injections.
Of even greater concern are the potential side effects of Botox TMD treatment, ranging from headaches and soreness at the injection site to more serious muscle atrophy and possible facial deformity from repeated injections. There's also evidence for decreased bone density in the jaw, which could have far-reaching consequences for someone with TMD.
The best approach still seems to lie in the more conservative therapies that treat TMD similar to other joint disorders. Finding the right combination of therapies that most benefit you will help you better manage your symptoms.
If you would like more information on treatments for TMD, 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 “Botox Treatment for TMJ Pain.”
Root canals often get a bum rap. Although the procedure saves millions of teeth every year, it's often erroneously portrayed as an unpleasant experience. And if that wasn't enough, a long-discredited medical theory has found new life on the internet asserting root canals are a health danger.
First off, root canals play an immensely important role in treating teeth with advanced decay. If not promptly treated, a cavity can turn into a major infection of the interior tooth pulp and root canals, and ultimately the supporting bone. Teeth with this level of decay are not long for this world.
A root canal treatment stops this disease process in its tracks. After numbing the tooth and surrounding gums, we drill a small hole into the tooth's interior and then remove all of the infected tissue within the pulp and root canals. After disinfecting these areas, we fill them with a rubber-like substance called gutta percha.
After sealing off the access hole—and later capping the tooth with a life-like crown—the tooth is secure from further decay. And, by the way, the procedure doesn't hurt, thanks to local anesthesia. If anything, any pain caused by the decay attacking the tooth's nerves has now been alleviated.
So, what about the idea floating on the Web that root canals are dangerous? The "root" for this conjecture is a theory by Weston Price, an early 20th Century dentist, that leaving a "dead" body part in the body leads to various health problems (including cancer). That would include a root-canaled tooth, which has had the living tissue in the pulp removed.
There's just one problem—Weston's theory was fully investigated in the 1950s and overwhelmingly discredited. The supposed cancer threat was also reviewed in a 2013 study, which found no link between root canals and increased cancer risk. In fact, dental patients who had undergone several root canals had a diminished risk.
Like all other health procedures, root canals have some risks of complication. But those complications are far from life-threatening—it's tooth-saving benefits are often worth the risk. So, fear not if your dentist says you need a root canal. It won't hurt and it won't endanger your health—and it could save your tooth.
If you would like more information on root canal therapy, 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 “Root Canal Safety.”
If you've decided on a dental implant to replace a missing tooth, you've made a great choice. Implants are a big favorite of both dentists and patients, not only for their life-likeness, but also their durability. Studies show that more than 95% of implants survive after ten years.
As you may know, single tooth implants are composed of two main parts: a metal post (usually titanium) imbedded in the jawbone; and a life-like crown affixed to the end of the post. But what you may not know is that there are two ways to attach the crown—either with screws or with dental cement.
Neither way is superior to the other—both have their own set of advantages and disadvantages. A cemented crown, for instance, usually looks more like a natural tooth than a screw-retained crown (more about that later) and dentists have more flexibility in making them look natural.
But cemented crowns require an additional piece of hardware called an abutment to better match it with the implant, something unnecessary with a screw-retained crown. Some people can also experience a reaction to the cement resulting in inflammation or even bone loss. And once installed, removing the crown later for repair or replacement is much more difficult than with a screw-retained crown.
Besides attaching directly to the implant, screw-retained crowns don't require cement and are more easily attached and removed. But the screw-hole can pose some aesthetic problems: Although it can be filled with a tooth-colored filling, the tooth's appearance isn't as ideal as a cemented crown.
So, which one is best for you? That will depend on the type and location of teeth being replaced, as well as your dentist's preferences. For instance, a more attractive cemented crown may be better for a visible front tooth, while a screw-retained crown might be a good choice for a back premolar or molar where appearance isn't as big a factor.
In the end, it's likely your dentist will discuss the pros and cons for each method as it pertains to your individual case. Whichever way your crown attaches, the end result will still be a life-like tooth that could last you for years to come.
If you would like more information on dental 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 article “How Crowns Attach to Implants.”
If your budget gets squeezed, cutting non-essential expenses can be a wise move. But think twice before lumping dental care into that category—postponing dental visits or treatment could put your long-term dental health at risk.
True, dental treatments can get expensive, so it's tempting to let a routine visit slide or put off treatment for an obvious problem. But dental problems usually don't go away on their own—rather, they worsen. When you do get around to treatment, you'll pay and endure more than if you had tackled the issue earlier.
The key isn't cutting out dental care altogether, but to sync your limited financial resources with your dental needs. Here are 4 tips to help you do that.
Focus on the long-term. Twice-a-year cleanings and checkups are the minimum investment you should make toward good dental health. Besides lowering your disease risk, these appointments are key to a long-term care plan. By evaluating your on-going health and assessing your personal risk for dental disease, we can formulate a plan that addresses current problems and prevents future ones.
Take care of your mouth. The single most important thing you can do to protect yourself against destructive dental diseases is to practice daily oral hygiene. Brushing and flossing removes dental plaque, the bacterial film on teeth most responsible for tooth decay and gum disease. You can further boost healthy teeth and gums by eating foods rich in vitamins and minerals.
Restore teeth temporarily. We may be able to treat or restore affected teeth with temporary materials that give you time to prepare financially for a more permanent solution later. Durable but low-cost materials like resin bonded glass ionomers for repairing decayed teeth, or a partial denture to replace teeth can get you by until you're ready for a crown or dental implants.
Manage your costs. There are different ways to minimize your dental expenses or spread them out over time to make it easier on your budget. You may be able to lower expenses with dental insurance or a dental savings plan. Your provider may also have payment plans that allow you to finance your fees over time.
If you would like more information on affordable dental care, 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 “Cost-Saving Treatment Alternatives.”
Although the air we breathe has one destination—the lungs—it can arrive there via two possible routes: through the nose or the mouth. In terms of survival, it matters little through which path air travels—just so it travels one of them!
In terms of health, though, breathing through the nose is more beneficial than through the mouth, and is our default breathing pattern. The nasal passages filter minute noxious particles and allergens. Air passing through these passages also produces nitric oxide, a gaseous substance that relaxes blood vessels and improves blood flow.
On the other hand, chronic mouth breathing during childhood can impact oral health. While breathing through the nose, the tongue rests against the roof of the mouth and thus becomes a mold around which the upper jaw and teeth develop. But mouth breathing places the tongue on the lower teeth, which deprives the upper jaw of support and can lead to an abnormal bite.
So why would people breathe through their mouth more than their nose? Simply put, it's more comfortable to do so. Because breathing is so critical for life, the body takes the path of least resistance to get air to the lungs. If obstructions caused by allergic reactions or swollen tonsils or adenoids are blocking the nasal pathway, the action moves to the mouth.
But chronic mouth breathing can often be treated, especially if addressed in early childhood. This may require the services of an ear, nose and throat specialist (ENT) and possible surgical intervention to correct anatomical obstructions. It's also prudent to have an orthodontist evaluate the bite and institute corrective interventions if it appears a child's jaw development is off-track.
Even after correcting obstructions, though, it may still be difficult for a child to overcome mouth breathing because the body has become habituated to breathing that way. They may need orofacial myofunctional therapy (OMT), which retrains the muscles in the face and mouth to breathe through the nose.
Chronic mouth breathing isn't something to be ignored. Early intervention could prevent future oral and dental problems and help the person regain the overall health benefits for nose breathing.
If you would like more information on overcoming chronic mouth breathing, 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 “The Trouble With Mouth Breathing.”