Posts for category: Oral Health
Have you noticed a clicking, popping, or grating sound when you open or close your jaw? As many as 36 million U.S. adults experience this phenomenon in one or both of the joints that connect the lower jaw (mandible) to the skull.
While the sounds may be disconcerting, there’s generally no cause for concern in the absence of other symptoms. They’re most likely caused by a harmless shift in the position of the disk inside each temporomandibular (jaw) joint, and it can diminish or disappear entirely over time. But, if you’re also experiencing persistent discomfort, severe pain, or limited function in your jaw (which can include getting it “stuck” in an opened or closed position), then you may be suffering from a temporomandibular joint disorder — part of a complex set of conditions affecting one or both jaw joints, muscles and/or other surrounding tissues. (You may have heard the condition called TMJ, which is actually the abbreviation for the temporomandibular joint itself. Health care professionals prefer TMJD or TMD.)
Depending on the severity, TMD can interfere with your ability to speak, chew and even make facial expressions. The cause is unclear, but genes, gender, environment, stress and behavior are believed to play a role. It can also be symptomatic of a larger medical problem, such as fibromyalgia, which can produce pain all over the body.
Management Options for TMD
TMD traditionally was viewed as a bite problem (malocclusion) requiring mechanical correction — e.g., through orthodontic braces or surgery. But the current therapeutic model approaches TMD as an orthopedic problem (joint inflammation, muscle soreness, strained tendons and ligaments, and disk damage) and favors a sequence of conservative, reversible procedures — hot or cold compresses in the jaw area, soft foods, physical therapy/massage, medication, and/or a bite guard to decrease pressure on jaw joints from tooth clenching and grinding — prior to more aggressive, irreversible treatment alternatives.
If you would like more information about TMD, please contact us or schedule an appointment for a consultation. You can also learn more about the subject by reading the Dear Doctor magazine articles “Seeking Relief from TMD” and “Chronic Jaw Pain and Associated Conditions.”
Some people are lucky — they never seem to have a mishap, dental or otherwise. But for the rest of us, accidents just happen sometimes. Take actor Jamie Foxx, for example. A few years ago, he actually had a dentist intentionally chip one of his teeth so he could portray a homeless man more realistically. But recently, he got a chipped tooth in the more conventional way… well, conventional in Hollywood, anyway. It happened while he was shooting the movie Sleepless with co-star Michelle Monaghan.
“Yeah, we were doing a scene and somehow the action cue got thrown off or I wasn't looking,” he told an interviewer. “But boom! She comes down the pike. And I could tell because all this right here [my teeth] are fake. So as soon as that hit, I could taste the little chalkiness, but we kept rolling.” Ouch! So what's the best way to repair a chipped tooth? The answer it: it all depends…
For natural teeth that have only a small chip or minor crack, cosmetic bonding is a quick and relatively easy solution. In this procedure, a tooth-colored composite resin, made of a plastic matrix with inorganic glass fillers, is applied directly to the tooth's surface and then hardened or “cured” by a special light. Bonding offers a good color match, but isn't recommended if a large portion of the tooth structure is missing. It's also less permanent than other types of restoration, but may last up to 10 years.
When more of the tooth is missing, a crown or dental veneer may be a better answer. Veneers are super strong, wafer-thin coverings that are placed over the entire front surface of the tooth. They are made in a lab from a model of your teeth, and applied in a separate procedure that may involve removal of some natural tooth material. They can cover moderate chips or cracks, and even correct problems with tooth color or spacing.
A crown is the next step up: It's a replacement for the entire visible portion of the tooth, and may be needed when there's extensive damage. Like veneers, crowns (or caps) are made from models of your bite, and require more than one office visit to place; sometimes a root canal may also be needed to save the natural tooth. However, crowns are strong, natural looking, and can last many years.
But what about teeth like Jamie's, which have already been restored? That's a little more complicated than repairing a natural tooth. If the chip is small, it may be possible to smooth it off with standard dental tools. Sometimes, bonding material can be applied, but it may not bond as well with a restoration as it will with a natural tooth; plus, the repaired restoration may not last as long as it should. That's why, in many cases, we will advise that the entire restoration be replaced — it's often the most predictable and long-lasting solution.
Oh, and one more piece of advice: Get a custom-made mouthguard — and use it! This relatively inexpensive device, made in our office from a model of your own teeth, can save you from a serious mishap… whether you're doing Hollywood action scenes, playing sports or just riding a bike. It's the best way to protect your smile from whatever's coming at it!
If you have questions about repairing chipped teeth, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine articles “Artistic Repair of Chipped Teeth With Composite Resin” and “Porcelain Veneers.”
We don’t often think about it, but eating is a multi-staged process. It starts, of course, with food that’s hopefully high in nutritional value. But you also need coordinated jaw action to chew and shred your food that when combined with the enzymes in saliva can then be effectively digested in the stomach.
But what if you’re unable to chew some foods because you suffer from chronic jaw pain and dysfunction? This is the situation for millions of people who suffer from problems associated with the jaw joints—temporomandibular joint disorders (TMD). It’s not just the chronic pain and discomfort TMD can cause that’s a real issue—it may also be preventing you from eating foods that are healthy for you.
Because TMD can make it difficult to open your jaws wide or causes pain when you bite down, you might especially have trouble with certain fruits and vegetables as well as many meats. Many people opt to skip otherwise healthy foods because they’re too difficult to eat. That, however, could lead to lack of proper nutrition in the long run.
But with a few techniques and modifications, you can still include many of these foods in your diet even when TMD discomfort flares up. For one, be sure to cut all your food portions (including toast) into small, bite-sized pieces. These should be small enough to limit the amount of jaw opening required to comfortably place the bite in your mouth and chew. When preparing your food, be sure to peel fruits and vegetables that have skin, which is often hard to chew.
You should also try cooking crisper fruits and vegetables to a soft, moist texture. Choose meat cuts, poultry or seafood that can be cooked to a tender, moist consistency—you can also use gravies and sauces to further moisten them.
And don’t forget to chew slowly. Not only does slower eating aid in digestion, it will help you avoid overworking your jaw joints.
With a few adjustments you can have a normal, nutritious diet and minimize the discomfort of your TMD symptoms. Continual healthy eating is a must for overall health and quality of life.
If you would like more information on reducing the impact of TMD on your life and health, 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 “What to Eat When TMJ Pain Flares Up.”
Today’s dental care has advanced leaps and bound over the last century. But these advances are tiny steps compared to what many believe may be coming in the next few decades. This optimism arises from our growing understanding of deoxyribonucleic acid (DNA), the chain-like molecule that houses the genetic instructions for the growth, function and reproduction of every cell in the body.
As researchers unlock the secrets of this vast genetic blueprint unique to each individual the possible applications from this knowledge are astounding. Here are just a few possibilities that could one day impact everyone’s oral health.
Preventing tooth decay. This rampant disease, triggered by bacteria (particularly Streptococcus mutans), can cause extensive damage in otherwise healthy teeth. There’s already some indications from the study of genomics that we may be able to stop or at least hinder this disease in its tracks. Already we’re seeing advances in gene therapy that might be able to inhibit the growth of Strep mutans and reduce its colonies in the mouth.
Growing new teeth. Composed of various layers, a natural tooth is part of a dynamic system of bone and gum ligaments that allow movement, protection and nourishment. Although dental implants are the closest and most advanced artificial approximation we now have to them, implants still can’t fully measure up to the function and capabilities of a natural tooth. But further insight into the genetic code may one day allow us to reproduce a living replacement tooth for a lost one.
Harnessing saliva for detecting disease. The impact of genomics related to the mouth could impact more than just the mouth itself. Researchers have discovered that saliva contains genetic information similar to blood, urine and other bodily fluids with markers for various disease conditions. Unlike other fluids, though, saliva is relatively easy to collect. The key is new equipment and testing protocols to take advantage of the information already available in a single drop of saliva.
These examples illustrate the range of possibilities for better health in the future: a reduction in dental disease early in life; new and better ways to restore missing teeth; and quicker ways to diagnose dangerous health conditions.
If you would like more information on new developments in 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 “The Future of Dentistry: A Sneak Preview of Your Dental Future.”
Not coincidentally, GERD Awareness Week overlaps with the Thanksgiving holiday. Many people get acid indigestion from time to time, especially during this month of major feasting, but if you suffer from more than occasional acid reflux, you may be among the 20 percent of U.S. adults with gastroesophageal reflux disease, or GERD. For many individuals, painful heartburn often accompanies acid reflux; however, for others there are few or no symptoms. In the latter situation, dentists may be the first to suspect GERD based on what we see during a regular dental exam.
With GERD, acid washes up from the stomach into the esophagus or throat, and even into the mouth. If the condition is not treated, the repeated contact with acid can lead to ulcers and cause pre-cancerous cell changes along the esophagus lining. In addition, the acids can eat away at tooth enamel and harm the soft tissues of the mouth, which may result in severely eroded teeth and chronic gum disease. Unfortunately for those who have relatively minor symptoms, GERD may go undetected until serious damage has been done. For this reason, diagnosis and treatment of GERD is very important.
You can play a big role in managing your GERD symptoms. Besides taking any over-the-counter or prescription medication your doctor recommends, you can help control acid reflux by eating smaller meals, avoiding foods and beverages that trigger heartburn, refraining from eating within three hours of bedtime, and resisting the urge to recline right after eating. Also, quitting smoking and taking off extra weight can help greatly.
Further, it is important to take steps to protect your teeth if you suffer from GERD. Here are some tips:
- Neutralize acid by chewing on an antacid tablet or rinsing your mouth with half a teaspoon of baking soda mixed into a cup of water.
- Don't brush your teeth immediately after an episode of acid reflux, as this could damage the weakened tooth enamel. Instead, rinse your mouth with water to dilute the acid and wait an hour before you brush to allow your saliva to rebuild the minerals on the surface of your teeth.
- Schedule regular dental visits to monitor the health of your teeth and gums. Depending on your specific situation, we may recommend a particular treatment to help strengthen your teeth.
Our goal is to help you preserve your teeth for life, so be sure to tell us if you have been diagnosed with GERD or any other medical condition. If you have questions, contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “GERD and Oral Health” and “Tooth Decay: How to Assess Your Risk.”