Your temporomandibular joints (TMJ), located where your lower jaw meets the skull, play an essential role in nearly every mouth function. It’s nearly impossible to eat or speak without them.
Likewise, jaw joint disorders (temporomandibular joint disorders or TMD) can make your life miserable. Not only can you experience extreme discomfort or pain, your ability to eat certain foods or speak clearly could be impaired.
But don’t assume you have TMD if you have these and other symptoms — there are other conditions with similar symptoms. You’ll need a definitive diagnosis of TMD from a qualified physician or dentist, particularly one who’s completed post-graduate programs in Oral Medicine or Orofacial Pain, before considering treatment.
If you are diagnosed with TMD, you may then face treatment choices that emanate from one of two models: one is an older dental model based on theories that the joint and muscle dysfunction is mainly caused by poor bites or other dental problems. This model encourages treatments like orthodontically moving teeth, crowning problem teeth or adjusting bites by grinding down tooth surfaces.
A newer treatment model, though, has supplanted this older one and is now practiced by the majority of dentists. This is a medical model that views TMJs like any other joint in the body, and thus subject to the same sort of orthopedic problems found elsewhere: sore muscles, inflamed joints, strained tendons and ligaments, and disk problems. Treatments tend to be less invasive or irreversible than those from the dental model.
The newer model encourages treatments like physical therapy, medication, occlusive guards or stress management. The American Association of Dental Research (AADR) in fact recommends that TMD patients begin their treatment from the medical model rather than the dental one, unless there are indications to the contrary. Many studies have concluded that a majority of patients gain significant relief with these types of therapies.
If a physician or dentist recommends more invasive treatment, particularly surgery, consider seeking a second opinion. Unlike the therapies mentioned above, surgical treatments have a spotty record when it comes to effectiveness — some patients even report their conditions worsening afterward. Try the less-invasive approach first — you may find improvement in your symptoms and quality of life.
If you would like more information on treating TMD, 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.”
With smart phone in hand, you can instantaneously find out just about anything. Unfortunately, online search results aren’t always accurate. Case in point: there’s an idea floating on the World Wide Web that root canal treatments cause cancer.
Sounds ludicrous? Yes, but like other strange ideas this one has historical roots (pardon the pun). In the early 20th Century, a dentist named Weston Price propagated the idea that leaving a “dead” organ in the body caused health problems. By his view, a root canal-treated tooth fell into this category and could potentially cause, among other things, cancer.
But concern over root canal treatment safety is on shaky ground: dentistry examined Dr. Price’s ideas over sixty years ago and found them wanting. But first, let’s look at what a root canal treatment can actually do for your health.
Tooth decay is an infection that first attacks the outer tooth enamel and then continues to advance until it infects the inner pulp. It can then travel through the root canals to the roots and bone. Without intervention, the infection will result in tooth loss.
We use a root canal treatment to save the tooth from this fate. During the procedure we remove and disinfect all of the diseased or dead tissue within the pulp and root canals. We then fill the empty chamber and canals with a special filling and seal the tooth to prevent any further infection. And while technically the procedure renders a tooth unable to respond to thermal sensitivity or tooth decay, the tooth is still alive as it is attached to the periodontal ligament and its blood supply and nerve tissue. The tooth can still “feel” if you bite on something too hard and it doesn’t affect the tooth’s function or health, or a patient’s overall health for that matter.
As to Dr. Price’s theory, extensive studies beginning in the 1950s have examined the potential health risk of root canal treatments. The latest, a 2013 patient survey study published in a journal of the American Medical Association, not only found no evidence linking root canal treatment to cancer, but a lower risk of oral cancer in 45% of patients who had undergone multiple root canal treatments.
While root canal treatments do have potential side effects, none are remotely as serious as this online “factoid” about cancer. It’s far more likely to benefit your health by saving your tooth.
If you would like more information on root canal treatment, 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 “Root Canal Safety.”
When a tooth is beyond repair due to disease or injury, it may be necessary to remove it. A “simple” tooth extraction is among the most common in dentistry and certainly not the agonizing procedure depicted in common lore.
They’re referred to as simple extractions because the shape of the tooth and root allows for a fairly straightforward and uncomplicated removal. An example would be the normally cone-shaped upper front tooth that doesn’t offer a lot of resistance during the extraction process.
The process itself is fairly straightforward. Teeth are held in place by the periodontal ligament, an elastic tissue made of tiny fibers that attaches the tooth to the supporting bone. These fibers can be dislodged from the tooth with some careful manipulation — in the hands of an experienced dentist there’s a deft “feel” to the fibers loosening. Once they’ve detached, it requires little effort to remove the tooth; with the aid of local anesthesia, you won’t feel anything but a little pressure.
Immediately after the tooth is removed, we commonly insert bone grafting material in the socket to minimize bone loss until a permanent replacement like a dental implant can be installed after tissue healing. We then place sterile gauze over the site for a few minutes to control bleeding and, depending on the size of the wound opening, we may also place a few stitches to close it. We then give you instructions for caring and cleaning the site over the next few days, and prescribe antibiotics to reduce the chance of infection and anti-inflammatory drugs for any discomfort.
Although a simple extraction is a routine procedure, it’s important to perform a proper assessment of the tooth and the surrounding bone beforehand, including x-rays to determine the tooth’s exact shape and position. If we discover a complication that makes a simple extraction impractical (like multiple roots at acute angles), we may then refer you to an oral surgeon for a more complicated surgical extraction.
It’s our hope you’ll have your natural teeth for as long as you live. But if you must have one removed, you can rest assured it’s a common — and uneventful — experience.
If you would like more information on tooth extraction, 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 “Simple Tooth Extraction.”
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.”
To get your child on the right track for lifelong dental health we recommend you begin their dental visits around their first birthday. You can certainly visit your family dentist, especially if you and your family feel comfortable with them. But you also might want to consider a pediatric dentist for your child's dental needs.
What's the difference between a family dentist and a pediatric dentist? Both offer the same kind of prevention and treatment services like cleanings, fluoride applications or fillings. But like their counterparts in medicine — the family practice physician and pediatrician — the family dentist sees patients of all ages; the pediatric dentist specializes in care for children and teens only.
In this regard, pediatric dentists undergo additional training to address dental issues specifically involving children. Furthermore, their practices are geared toward children, from toys and child-sized chairs in the waiting room to “kid-friendly” exam rooms decorated to appeal to children.
While your family dentist could certainly do the same, pediatric dentists are also skilled in reducing the anxiety level that's natural for children visiting the dental office. This can be especially helpful if you have a special needs child with behavioral or developmental disorders like autism or ADHD. A pediatric dentist's soothing manner and the calm, happy environment of the office can go a long way in minimizing any related anxiety issues.
Your child may have other needs related to their oral health that could benefit from a pediatric dentist. Some children have a very aggressive form of dental caries disease (tooth decay) called early childhood caries (ECC).Â If not treated promptly, many of their teeth can become severely decayed and prematurely lost, leading to possible bite problems later in life. Pediatric dentists are well-suited to treat ECC and to recognize other developmental issues.
Again, there's certainly nothing wrong with taking your child to your family dentist, especially if a long-term relationship is important to you (your child will eventually “age out” with a pediatric dentist and no longer see them). It's best to weigh this and other factors such as your child's emotional, physical and dental needs before making a decision.
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