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.”
Have you ever felt a hot, burning sensation in your mouth—like it had been scalded—but you didn't eat or drink anything that could have caused it?
While you may think you’re hallucinating, there’s another possibility: Burning Mouth Syndrome (BMS). This condition, which can last for years, produces sensations in the mouth of not only scalding or burning, but also tingling, numbness and a decline in your ability to taste. Patients may feel it throughout their mouth or only in localized areas like the lips, tongue or inside the cheeks.
The exact cause of BMS is also something of a mystery. It’s been theoretically linked to diabetes, vitamin or mineral deficiencies and psychological problems. Because it’s most common among women of menopausal age hormonal changes have been proposed as a factor, although hormone replacement therapy often doesn’t produce any symptomatic relief for BMS.
To complicate matters, other conditions often share the condition’s effects, which need to be ruled out first to arrive at a BMS diagnosis. A feeling of scalding could be the result of mouth dryness, caused by medications or systemic conditions that inhibit saliva flow. Some denture wearers may display some of the symptoms of BMS due to an allergic reaction to denture materials; others may have a similar reaction to the foaming agent sodium lauryl sulfate found in some toothpaste that can irritate the skin inside the mouth.
If these other possibilities can be ruled out, then you may have BMS. While unfortunately there’s no cure for the condition, there are ways to lessen its impact. There’s even the possibility that it will resolve itself over time.
Until then, keep your mouth moist by drinking lots of water or using saliva-stimulating products, limiting alcohol, caffeinated drinks or spicy foods and refraining from smoking. If you’re taking medications that could cause dry mouth, speak with your physician about changing to an alternative. And try to reduce stress in your life through exercise, mindfulness practices or support groups.
While BMS isn’t considered harmful to your physical health it can make life less enjoyable. Careful symptom management may help improve your quality of life.
If you would like more information on Burning Mouth Syndrome, 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 “Burning Mouth Syndrome: A Painful Puzzle.”
Think dental implants only replace individual teeth? Think again—this premier technology can also support other kinds of restorations to provide better stability and comfort. And, they also help improve bone health when incorporated with any type of tooth replacement options, especially dentures.
Although traditional dentures have enjoyed a long, successful history as a tooth replacement solution, they can interfere with bone health. That’s because regular dentures fit in the mouth by resting on the bony ridges of the jaw, which has implications for the bone.
As living tissue, bone goes through a growth cycle with older bone cells dying and dissolving and newer cells forming to take their place. The teeth play a role in this growth cycle — the forces generated when we chew travel up through the teeth and help stimulate bone growth. When teeth go missing, however, so does this stimulus.
Traditional dentures can’t replace this missing stimulus. In fact, the constant pressure of dentures on the jaw may even accelerate bone loss. A sign this is happening occurs when the dentures’ once tight fit begins to loosen and they become uncomfortable to wear.
Implant-supported dentures can help eliminate this problem. We first surgically place a few implants in the jaw, the number determined by which jaw (the lower requires less) and whether the denture is removable or fixed. If removable, the denture has connective points that match the implant locations — you simply connect them with the implants. If fixed, the denture is screwed into the implants to hold it in place.
So, how does this help bone health? For one, the denture no longer puts as much pressure on the jaw ridges—the main support comes from the implants. And, the implants themselves encourage bone stimulation: The titanium in the implant has a special affinity with bone cells that naturally grow and adhere to its metal surface. This natural integration between implant and bone can stop bone loss and may even help reverse it.
If you’re interested in implant-supported dentures, you’ll first need to undergo a full dental exam with your dentist. These restorations aren’t appropriate for all dental situations. But, if they can work for you, you may be able to enjoy the benefits of an implant-supported restoration.
If you would like more information on implant-supported restorations, 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 “Overdentures & Fixed Dentures.”
Professional Hockey player Keith Yandle is the current NHL “iron man”—that is, he has earned the distinction of playing in the most consecutive games. On November 23, Yandle was in the first period of his 820th consecutive game when a flying puck knocked out or broke nine of his front teeth. He returned third period to play the rest of the game, reinforcing hockey players’ reputation for toughness. Since talking was uncomfortable, he texted sportswriter George Richards the following day: “Skating around with exposed roots in your mouth is not the best.”
We agree with Yandle wholeheartedly. What we don’t agree with is waiting even one day to seek treatment after serious dental trauma. It was only on the following day that Yandle went to the dentist. And after not missing a game in over 10 years, Yandle wasn’t going to let a hiccup like losing, breaking or cracking nearly a third of his teeth interfere with his iron man streak. He was back on the ice later that day to play his 821st game.
As dentists, we don’t award points for toughing it out. If anything, we give points for saving teeth—and that means getting to the dentist as soon as possible after suffering dental trauma and following these tips:
- If a tooth is knocked loose or pushed deeper into the socket, don’t force the tooth back into position.
- If you crack a tooth, rinse your mouth but don’t wiggle the tooth or bite down on it.
- If you chip or break a tooth, save the tooth fragment and store it in milk or saliva. You can keep it against the inside of your cheek (not recommend for small children who are at greater risk of swallowing the tooth).
- If the entire tooth comes out, pick up the tooth without touching the root end. Gently rinse it off and store it in milk or saliva. You can try to push the tooth back into the socket yourself, but many people feel uneasy about doing this. The important thing is to not let the tooth dry out and to contact us immediately. Go to the hospital if you cannot get to the dental office.
Although keeping natural teeth for life is our goal, sometimes the unexpected happens. If a tooth cannot be saved after injury or if a damaged tooth must be extracted, there are excellent tooth replacement options available. With today’s advanced dental implant technology, it is possible to have replacement teeth that are indistinguishable from your natural teeth—in terms of both look and function.
And always wear a mouthguard when playing contact sports! A custom mouthguard absorbs some of the forces of impact to help protect you against severe dental injury.
If you would like more information about how to protect against or treat dental trauma or about replacing teeth with dental implants, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Dental Implants: A Tooth-Replacement Method That Rarely Fails” and “The Field-Side Guide to Dental Injuries.”
‘Tis the season to be merry—and with plenty of edible goodies! During the holidays, families fill their homes with all sorts of delectable treats for friends and loved ones. But there can be unintended consequences with all this joyous feasting, and not just added pounds come January: eating more sugar could increase your risk for dental disease.
We’re not here to throw a wet blanket on your holiday fun. Instead, we have 4 commonsense tips to help you keep your holiday snacking from ultimately causing tooth and gum woes.
Blend in healthier choices. The problem with sugar is that it’s a prime food source of disease-causing oral bacteria. The more sugar available in the mouth, the more these bacteria multiply and increase the disease threat to your teeth and gums. So, try reducing sugar by adding savory treats like nuts or flavored popcorn to your sweeter offerings. And don’t forget cheese and other dairy—eating dairy products along with sweets can help blunt some of sugar’s effect on bacteria.
Avoid “grazing.” While it’s tempting to do so during the holidays, continuous snacking increases the mouth’s acidity, which is like Superman’s kryptonite to your tooth enamel. The longer acid directly contacts your enamel, the more it can soften it and open the door to tooth decay. Saliva neutralizes after-meal acid; but if you’re constantly snacking, you could prevent saliva from completely buffering the acid present. So, limit your snacking time—or better yet, reserve your sweet treats for mealtime.
Don’t neglect your hygiene. The hectic pace of the holidays can interfere with people’s normal routines. Don’t let that happen to your daily practice of brushing and flossing. These essential hygiene tasks clean your teeth of a disease-causing biofilm called dental plaque. Miss a few days and the accumulated plaque could trigger an infection that could damage your gums and ultimately your teeth. You can help avoid this by brushing and flossing every day.
Don’t brush right after eating. The mouth’s acidity naturally increases during and just after eating. As we alluded to earlier, saliva’s on the job getting the mouth back to a more neutral state and reducing the effect of acid on enamel. That takes about an hour, though, and in the meantime your enamel may be in a slightly softened state. If you brush right after eating, you might inadvertently brush tiny bits of enamel. So, wait an hour or so after eating before you brush.
The holidays are all about enjoying friends and family and ringing in the new year. Follow these tips to ensure it’s a healthy and happy one for your teeth and gums.
If you would like more information about dental care during the holidays, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine article “6 Tips to Help Prevent the Erosion of Tooth Enamel.”
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