If you have chronic jaw pain, you know how difficult eating, speaking or even smiling can be. Many sufferers will do anything to gain relief, even surgery. But before you go down that road, consider the traditional conservative approach to temporomandibular disorders (TMD) management first—it could provide the most relief with the least risk of side effects.
The temporomandibular joints connect the lower jaw to the skull on either side of the head. These ball and socket joints also contain a cushioning disk to facilitate movement. This disk is believed to be the primary focus for jaw pain problems known collectively as TMD.
Doctors now believe injury, stress, metabolic issues, jaw anatomy defects or similar factors trigger the chain reaction of muscle spasms, pain and soreness that can erupt during a TMD episode. A TMD patient may experience pain within the jaw muscles or joints themselves, clicking sensations, or an inability to open the jaw to its full range.
TMD therapy has traditionally followed an orthopedic path—treating jaw joints like any other joint. In recent years, though, a more aggressive treatment model has emerged that promotes more invasive techniques like orthodontics, dental work or jaw surgery to relieve discomfort. But the track record for this model, especially concerning jaw surgery, remains hazy at best and offers no guarantee of relief. These techniques are also irreversible and have even made symptoms worse in some patients.
It’s usually prudent, then, to try conservative treatments first. This can include pain and muscle relaxant medication, jaw exercises, stretching and massage, and dietary changes to reduce chewing force. Patients with teeth grinding habits may also benefit from a bite guard worn at night to reduce the biting force during sleep and help the joints relax.
By finding the right mix of treatments, you may be able to find significant relief from TMD symptoms with the conservative approach. If not, you might then discuss more invasive options with your dentist. But even if your dentist recommends such a procedure, you would be wise to seek a second opinion.
TMD can definitely interfere with your quality of life and peace of mind. But there are ways to reduce its effects and make for a happier life.
If you would like more information on managing chronic jaw pain, 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.”
What's your favorite winter sport? For some, it's all about swooshing down a snowy trail on skis, a board, or a sled. For others, the main attraction is skating at an ice rink or a frozen pond. If you're more of an indoors athlete, you may enjoy a fast-moving game of basketball or a round of squash. Or, you might take a turn on a climbing wall or a trampoline.
What do all these activities have in common? They're fun, they're great exercise…and they all come with a risk of injury to your teeth.
It's easy to see how a collision on snow or ice could result in a blow to the mouth. But did you know that basketball (along with hockey) is among the sports with the highest risk of facial injury? What's more, many "non-contact" sports actually have a similar risk.
Located front and center in the face, the incisors (front teeth) are the ones most likely to sustain injury. Unfortunately, they are also the most visible teeth in your smile. With all of the advances in modern dentistry, it's possible to restore or replace damaged teeth in almost any situation—but the cost can be high, both for present restoration and future preservation. Is there a better alternative?
Yes! It isn't sitting at home—it's wearing a custom-made mouthguard when there's a risk of facial injury.
Most people don't ski or play hockey without protective gear like a helmet. A mouthguard can effectively protect against dental injury that might otherwise be serious. Available here at the dental office, a custom mouthguard is made from an exact model of your own teeth, so it's comfortable to wear and fits perfectly—but no safety equipment can work if you don't use it!
So whether you like to hit the trails or the gym this winter, don't forget to bring a custom-made mouthguard. It's a small piece of gear that can save you from a big headache!
If you would like more information on mouthguards, please contact us or schedule a consultation. You can learn more by reading the Dear Doctor magazine articles “Athletic Mouthguards” and “An Introduction to Sports Injuries & Dentistry.”
You probably wouldn't be surprised to hear that someone playing hockey, racing motocross or duking it out in an ultimate fighter match had a tooth knocked out. But acting in a movie? That's exactly what happened to Howie Mandel, well-known comedian and host of TV's America's Got Talent and Deal or No Deal. And not just any tooth, but one of his upper front teeth—with the other one heavily damaged in the process.
The accident occurred during the 1987 filming of Walk Like a Man in which Mandel played a young man raised by wolves. In one scene, a co-star was supposed to yank a bone from Howie's mouth. The actor, however, pulled the bone a second too early while Howie still had it clamped between his teeth. Mandel says you can see the tooth fly out of his mouth in the movie.
But trooper that he is, Mandel immediately had two crowns placed to restore the damaged teeth and went back to filming. The restoration was a good one, and all was well with his smile for the next few decades.
Until, that is, he began to notice a peculiar discoloration pattern. Years of coffee drinking had stained his other natural teeth, but not the two prosthetic (“false”) crowns in the middle of his smile. The two crowns, bright as ever, stuck out prominently from the rest of his teeth, giving him a distinctive look: “I looked like Bugs Bunny,” Mandel told Dear Doctor—Dentistry & Oral Health magazine.
His dentist, though, had a solution: dental veneers. These thin wafers of porcelain are bonded to the front of teeth to mask slight imperfections like chipping, gaps or discoloration. Veneers are popular way to get an updated and more attractive smile. Each veneer is custom-shaped and color-matched to the individual tooth so that it blends seamlessly with the rest of the teeth.
One caveat, though: most veneers can look bulky if placed directly on the teeth. To accommodate this, traditional veneers require that some of the enamel be removed from your tooth so that the veneer does not add bulk when it is placed over the front-facing side of your tooth. This permanently alters the tooth and requires it have a restoration from then on.
In many instances, however, a “minimal prep” or “no-prep” veneer may be possible, where, as the names suggest, very little or even none of the tooth's surface needs to be reduced before the veneer is placed. The type of veneer that is recommended for you will depend on the condition of your enamel and the particular flaw you wish to correct.
Many dental patients opt for veneers because they can be used in a variety of cosmetic situations, including upgrades to previous dental work as Howie Mandel experienced. So if slight imperfections are putting a damper on your smile, veneers could be the answer.
If you would like more information about veneers and other cosmetic dental enhancements, please contact us or schedule a consultation. To learn more, read the Dear Doctor magazine articles “Porcelain Veneers” and “Porcelain Dental Crowns.”
While it’s common for most of us to get an occasional cold sore, you may suffer from regular breakouts. If so, you know firsthand how uncomfortable and embarrassing they can be and seeming to erupt at the most inopportune moments.
What you’re experiencing is the result of a virus — the Herpes Simplex virus (HSV) Type I to be exact. Don’t let the name disturb you — although similar it’s different from the sexually transmitted virus known as HSV Type II. As with any virus the body responds by making and distributing antibodies to stop its attack. That’s typically the end of it but for some people the virus appears to be able to hide in the nerve roots of the mouth and elude the effects of the antibodies.
The sores associated with the virus tend to break out when a person is under stress, experiences trauma to the lip or even from sun exposure. The breakout begins with a slight itching or burning around the mouth that typically advances to more severe itching, swelling, redness and blistering. Eventually the sores will scab over and heal as the outbreak winds down. The period from breakout to final healing (during which you’ll also be contagious to others) usually lasts seven to ten days.
Although normally not a danger to health, cold sore outbreaks can be painful and irritating. In the past, most patients simply had to let the outbreak run its course with topical ointments to ease discomfort.Â In the last two decades, however, new anti-viral medication has proven effective in preventing the outbreaks in the first place or at least lessening their duration.
If you have regular bouts of cold sores prescription drugs like acyclovir or valcyclovir taken orally can help suppress the occurrences altogether, and have few side effects. Topical agents can also be used as a supplement to the drugs to help ease itching and other pain symptoms.
It’s important, though, that you undergo a complete oral examination to rule out more serious conditions associated with mouth sores. If we find that your problem is recurring cold sores, these new treatments could help you escape the cycle of discomfort.
If you would like more information on the treatment of chronic cold sore outbreaks, 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 “Cold Sores.”
A loose primary (“baby”) tooth is often a cause for celebration. A loose permanent tooth, however, is a cause for concern. A permanent tooth shouldn't even wiggle.
If you have a loose tooth, it's likely you have a deeper dental problem. Here are the top underlying causes for loose teeth.
Gum disease. Teeth are held in place by an elastic tissue called the periodontal ligament. But advanced periodontal (gum) disease, a bacterial infection usually caused by film buildup on teeth called dental plaque, can damage the ligament and cause it to detach. If it's not treated, it could lead to tooth loss.
Bite-related trauma. A normal bite helps balance out the forces generated when we chew so they don't damage the teeth. But if a misaligned tooth protrudes higher from the jaw, the opposing tooth will likely create more downward pressure on it while chewing. This can stress the tooth's supporting ligament to the point of looseness.
Self-inflicted trauma. While they may be trendy, tongue jewelry can cause dental damage. A wearer who clicks the “barbell” of a tongue stud against their teeth could be creating conditions conducive for gum damage and bone loss, which can cause tooth looseness. Similarly, taking orthodontics into your own hands could also damage your teeth, especially if you have undiagnosed gum disease.
Genetics. Although you can't prevent it, the type of resistance or susceptibility you inherited from your parents (as well as your dental anatomy) can cause you dental problems. Thinner gum tissues, especially around the roots, can make you more susceptible to gum disease or dental trauma, which in turn could contribute to tooth looseness.
There are things you can do to lessen your chance of loose teeth. Brush and floss every day to remove disease-causing bacterial plaque and see a dentist regularly for cleanings to reduce your risk of gum disease. If you have any misaligned teeth, consult with an orthodontist about possible treatment. And avoid oral jewelry and DIY orthodontics.
If you do notice a loose tooth, see us as soon as possible. We'll need to diagnose the underlying cause and create a treatment plan for it. We may also need to splint the tooth to its neighbors to stabilize it and reduce your risk of losing it permanently.
If you would like more information on tooth mobility, 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 “When Permanent Teeth Become Loose.”
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