Posts for: August, 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.”
If the words “root canal” frighten you, what you probably don't know is that “root canal treatment” doesn't cause pain, it alleviates it — by treating infection deep in the root of your tooth.
- What is a root canal? The central chamber of a tooth contains the living vital tissues comprising the pulp including its nerves and blood vessels. The interior of the tooth's roots containing the pulp make up its root canals.
- How do I know if a tooth has a root canal infection? Symptoms of root canal infection may include sharp, intense pain when you bite down, a dull ache or pressure, or tenderness and swelling in gums near an infected tooth. There may be lingering pain after eating cold or hot foods. However, sometimes an infected tooth may stop hurting and you no longer feel pain. This doesn't mean the infection has gone, only that the nerve may have died. Make an appointment if you suspect that you have any or some of these symptoms.
- Why would a tooth need root canal treatment? If the tissues in the root canal/s become infected or inflamed because of deep decay or trauma to a tooth, root canal treatment is needed to treat the infection and save the tooth. If left untreated, root canal infection can spread into the bone immediately around the root.
- What takes place in a root canal procedure? After a local anesthetic is administered to numb the tooth and surrounding area, a small opening is made in the biting surface for a back tooth, or behind a front tooth. Dead and/or dying tissue is removed from the pulp chamber and the root canals are cleaned, disinfected, and sealed to prevent future infection.
- What can I expect afterwards? Your tooth may feel tender or sensitive for a few days. You can take over-the-counter non-steroidal anti-inflammatory medication, aspirin or ibuprofen, for example, to relieve pain or discomfort. Contact us if you have pain that lasts more than a few days. A crown is usually needed to protect the tooth following root canal treatment. Further arrangements need to be made for this stage of the procedure. Don't chew on the affected tooth until symptoms subside and the tooth has been restored as necessary.
- Who performs root canal treatment? While all general dentists have received training in endodontic treatment and can perform most endodontic procedures, in complicated situations you may be referred to an endodontist, a specialist in root canal diagnosis and treatment.
Contact us today to schedule an appointment to discuss your questions about root canal treatment. You can learn more by reading the Dear Doctor magazine article “Common Concerns About Root Canal Treatment.”
Periodontics is a branch of dentistry that specializes in the supporting structures around the teeth, including the gums and bone, as well as the ligaments that join these structures to the tooth roots. From the Latin peri (“around”) and the Greek odont (“tooth”), periodontics serves one purpose: to keep these supporting structures healthy.
This specialty is critical when it comes to periodontal disease. The term actually refers to a category of inflammatory diseases that affect the periodontal tissues. The inflammation arises from the body's response to bacterial plaque that has collected at the gum line because of poor oral hygiene. It begins as gingivitis (inflammation of the gums), but if left untreated can develop into periodontitis, which results in bone loss. If left to continue, eventual tooth loss occurs.
Proper oral hygiene and regular cleanings are your best defense against developing periodontal disease in the first place. Once the disease gains a foothold in the area below the gum line, routine brushing and flossing will not be enough. To defeat the disease will require more aggressive treatment.
This usually begins in our office with oral hygiene instruction, scaling and root planing or debridement to rid the root surfaces of plaque and calcified deposits, also referred to as tartar or calculus. This may be followed up with a surgical procedure to remove any remaining pockets that were too deep to resolve with conservative treatment.
Another option we may add to your oral hygiene routine is the use of an anti-microbial mouthrinse, usually containing a 0.12% solution of chlorhexidine. We may also prescribe the use of a topically-applied antibiotic such as tetracycline to stop the infection and promote tissue healing.
Once the disease is arrested, it's important that you continue good oral hygiene practices. Vigilance and prevention are critical to keeping these all important structures around your teeth healthy and functioning.
If you would like more information on the diagnosis and treatment of periodontal disease, 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 “Treating Difficult Areas of Periodontal Disease.”
We humans have been cleaning our teeth for millennia. While the tools and substances have changed (we don't use twigs or pumice anymore), the reasons haven't: we want a nice, fresh smile and a clean-feeling mouth.
Objectively, though, oral hygiene has one primary purpose — to remove dental plaque, the whitish film of bacteria that grows on unclean tooth surfaces and at the gum line. Removing this decay-causing film can drastically reduce your risk of dental disease.
Effective oral hygiene depends on two primary tasks: brushing and flossing. You should perform these tasks at least once (flossing) or twice (brushing) in a 24-hour period. Brushing involves a simple technique. You hold your toothbrush (a well-designed, multi-tufted brush) in your fingertips with the same pressure as you would a pen or pencil. You then gently scrub all of the tooth surfaces starting at the gum line, holding the brush at a 45-degree. “Gently” is the key word here: it's possible to damage your tooth and gum surfaces by brushing too vigorously.
While brushing seems easier for people to fit into their daily routine, flossing seems to be harder. It's just as important, though, because over half of plaque accumulation occurs between teeth, in areas where brushing can miss. Like brushing, flossing isn't difficult to do. Holding a strip of floss taut by your fingers between both hands, and gently slipping the floss between your teeth you form a “C” shape around each tooth surface as you apply pressure onto the one surface you are cleaning. Gently move the floss up and down for three or four strokes or until you hear a squeaky clean sound (that's when you know the surface is clean). Then you go to the other tooth surface by lifting the floss above the gum line so that you don't damage the gum tissue in between the teeth.
You should also schedule regular checkups and cleanings with our office to supplement your daily routine. Professional cleanings remove any hidden plaque that brushing and flossing may have missed. A checkup also gives us a chance to evaluate how well your hygiene program is progressing. Our partnership in proper oral hygiene can make all the difference in you avoiding tooth decay and other dental diseases.
If you would like more information on proper oral hygiene, 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 “Oral Hygiene Behavior.”