Posts for: April, 2018
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.”
When they’re introducing a new movie, actors often take a moment to pay tribute to the people who helped make it happen — like, you know, their dentists. At least that’s what Charlize Theron did at the premiere of her new spy thriller, Atomic Blonde.
"I just want to take a quick moment to thank my dentists," she told a Los Angeles audience as they waited for the film to roll. "I don’t even know if they’re here, but I just want to say thank you."
Why did the starring actress/producer give a shout-out to her dental team? It seems she trained and fought so hard in the action sequences that she actually cracked two teeth!
“I had severe tooth pain, which I never had in my entire life,” Theron told an interviewer from Variety. At first, she thought it was a cavity — but later, she found out it was more serious: One tooth needed a root canal, and the other had to be extracted and replaced with a dental implant — but first, a bone grafting procedure was needed. “I had to put a donor bone in [the jaw] to heal,” she noted, “and then I had another surgery to put a metal screw in there.”
Although it might sound like the kind of treatment only an action hero would need, bone grafting is now a routine part of many dental implant procedures. The reason is that without a sufficient volume of good-quality bone, implant placement is difficult or impossible. That’s because the screw-like implant must be firmly joined with the jawbone, so it can support the replacement tooth.
Fortunately, dentists have a way to help your body build new bone: A relatively small amount of bone material can be placed in the missing tooth’s socket in a procedure called bone grafting. This may come from your own body or, more likely, it may be processed bone material from a laboratory. The donor material can be from a human, animal or synthetic source, but because of stringent processing techniques, the material is safe for human use. Once it is put in place your body takes over, using the grafted material as a scaffold on which to build new bone cells. If jawbone volume is insufficient for implants, it can often be restored to a viable point in a few months.
Better yet, when grafting material is placed in the tooth socket immediately after extraction, it can keep most of the bone loss from occurring in the first place, enabling an implant to be placed as soon as possible — even before the end of a movie’s shooting schedule.
Will Atomic Blonde prove to be an action-movie classic? Only time will tell. But one thing’s for sure: When Charlize Theron walks down the red carpet, she won’t have to worry about a gap in her smile.
If you have questions about bone grafting or dental implants, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Dental Implant Surgery” and “Immediate Dental Implant.”
There's more to your dental visit than preventing or treating teeth or gum problems. We're also on the lookout for a number of potential soft tissue problems that could occur in or around your mouth.
Here are 4 examples of such problems we can detect and help you manage.
Lumps. Whenever you accidentally bite the inside of your mouth, the wound you create forms a protective layer of hard collagen. Unfortunately, the “callous” can rise higher than the surrounding cheek surface and easily get in the way of your teeth again. With successive bites and more scar tissue you'll soon notice a prominent lump. Although not a health danger, it becomes annoying with each successive bite. We can surgically remove the lump and flatten out the mouth surface.
Canker sores. Known as aphthous ulcers, these round sores with a yellow-gray center and a red “halo” can break out on the inside cheeks, tongue or back of the throat. Unless they don't heal within a couple of weeks or seem to be increasing in frequency, they're nothing to worry about. They can, however, cause a burning or stinging sensation. We can reduce this discomfort and speed healing with over-the-counter ointments or prescription options like topical or injected steroids.
Cracked mouth corners. Also known as perleche (from the French lecher, meaning “to lick”), your mouth corners can become dry and irritated and you may begin licking them to soothe the discomfort. Accumulated saliva can trigger a yeast infection, which can spread to other parts of your mouth. We can usually prevent this by prescribing antifungal ointments, and a steroid ointment to control inflammation.
Mouth rash. Peri-oral dermatitis is a red, scaly rash that appears around the outside of the mouth. Because it's often mistaken for acne or other conditions, it's often treated with topical steroids. This actually suppresses the skin's normal healing effects and can actually make the rash worse. The best way to treat it is to stop using any kind of ointment or cream and use only mild soap to wash the area. We can also prescribe antibiotics to help speed the healing process.
If you would like more information on these and other soft tissue problems, 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 “Common Lumps and Bumps in the Mouth,” “Mouth Sores,” and “Cracked Corners of the Mouth.”
Our main focus as your dentist is to keep your teeth and gums healthy and functional. But there’s another important aspect of care — your teeth’s appearance. It’s not just a superficial concern: your smile can have a profound effect on your self-image, as well as your personal and professional relationships.
This is the realm of cosmetic dentistry: served by both specialists and general dentists, it focuses on altering your teeth’s appearance with treatments as basic as teeth whitening or as comprehensive as dental implants. The goal, however, is the same: a new, more attractive smile.
In a way, cosmetic dentistry begins with you and oral hygiene. The twin tasks of brushing and flossing to remove dental plaque not only lowers your risk for tooth decay or periodontal (gum) disease, they also improve the appearance of the tooth surface. There are, however, circumstances where otherwise healthy or repaired teeth may need extra cosmetic attention due to chipping, misshape or staining. In these cases, a truly cosmetic approach may be necessary.
One approach is to cover a tooth’s blemishes. Veneers, for example, are thin, layered pieces of dental porcelain shaped and colored like natural teeth that are bonded to the outside of an unattractive tooth. In other cases, a tooth may require a life-like porcelain crown that completely covers it to gain the same effect.
Missing teeth, of course, pose a different challenge, but here there are a wide range of solutions: dental implants, fixed bridgework or removable full or partial dentures. Advancements in dental materials and techniques can produce new teeth that are so life-like and natural that they’re imperceptible from the real thing.
Â These and other measures like orthodontics can all be used to turn a smile you find embarrassing into one you’re confident to share with the world. It begins, though, with both you and us taking a good, close look at your current smile — a smile analysis, if you will.
After assessing both your current needs and your expectations for change, we can develop an appropriate treatment plan. It might be quite simple or with multiple treatment stages, but it will be the best plan for you. Through cosmetic dentistry we have the means to help you achieve a new, more confident smile.
If you would like more information on the many ways to transform your smile, 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 “Cosmetic Dentistry: A Time for Change.”