Posts for: May, 2014
You have probably heard a lot of people talk about TMJ disorders, but do you know what it all means? How do you know if you are suffering from a TMJ disorder?
Below are answers to some common questions about TMJ disorders.
What is a TMJ disorder?
First, we should explain that TMJ actually refers to the Temporomandibular Joint, which is the formal name for your jaw joint(s). TMD stands for Temporomandibular Disorders, which is the correct name for the muscle and/or joint symptoms that commonly arise when there is TMJ pain and dysfunction. You may have heard people refer to the actual disorder as TMJ, but this name is incorrect.
When I experience TMJ pain, what exactly is happening?
Let's first understand all of the parts that play a role in your pain. The temporomandibular joints connect your mandible (lower jaw) to your skull on both the left and right sides, which makes the lower jaw the only bone in the body with completely symmetrical joints at both ends. There is a ball-and-socket relationship between your jaw and your skull on both sides, but the unique part is the presence of a cushioning disk between the two surfaces in each joint. Each TMJ has a disk between the ball (condyle) and socket (fossa), and this sometimes ends up being an especially important area when trouble arises.
So, how do I know if I have TMD?
You can never be absolutely sure, but here are some symptoms you should be sure to share with us during your examination:
- Clicking. You may experience a clicking sound in the jaw, usually due to a shift in the position of the disk inside the joint. However, if you do not have pain or limited jaw function, this symptom may be insignificant.
- Muscle Pain. The next symptom is jaw muscle pain, usually in the cheeks or temples. If the muscle is sore or stiff in the morning, this pain is usually related to clenching or grinding in your sleep. However, there are more complex muscle pains that can spread to your head and neck.
- TMJ Pain. This third symptom refers to pain actually inside one or both of your jaw joints, technically described as arthritis of the TMJ.
If diagnosed, what can I expect from treatment?
We will first need to assess the damage to your TMJ, and from there we will recommend a course of treatment to relieve your pain. Treatment may range from hot or cold compresses and anti-inflammatory medications to physical therapy or a bite guard. We may also advise you to do jaw exercises at home. In general, we will do our best to treat your issue without orthodontic treatment or surgery.
If you would like more information about TMD, please contact us or schedule an appointment for a consultation. You can also learn more by reading the Dear Doctor magazine article “Seeking Relief from TMD.”
What is tooth wear?
“Tooth wear” refers to a loss of tooth structure that can make your teeth appear shorter or less even than they used to be. Wear starts with loss of outer covering of the teeth, known as enamel. Although enamel is the hardest structure in the human body — even harder than bone — it can wear away over time. If enough enamel is lost, the softer inner tooth structure known as dentin can become exposed, and dentin wears away much faster.
What causes tooth wear?
Tooth wear can be caused by any of the following:
- Abrasion: This is caused by a rubbing or scraping of the teeth. The most common source of abrasion is brushing too hard or using a toothbrush that is not soft enough. A removable dental appliance, such as a partial dentures or retainer, can also abrade teeth. Abrasion can also result from habits such as nail-biting and pen-chewing.
- Attrition: This is caused by teeth contacting each other. Habits that you might not even be aware of — such as grinding or clenching your teeth — can be quite destructive over time. That’s because they can subject teeth to 10 times the normal forces of biting and chewing.
- Erosion: Acid in your diet can actually erode (dissolve) the enamel on your teeth. Many sodas, sports drinks and so-called energy drinks are highly acidic; so are certain fruit juices. Eating sugary snacks also raises the acidity level in your mouth. If you can’t give up these snacks and drinks entirely, it’s best to confine them to mealtimes so your mouth doesn’t stay acidic throughout the day. Swishing water in your mouth after eating or drinking acidic or sugary substances can also help prevent erosion.
- Abfraction: This refers to the loss of tooth enamel at the “necks” of the teeth (the part right at the gum line). This type of wear is not thoroughly understood, though it is believed to result from excessive biting forces. Abrasion and erosion can contribute to this problem.
How is it treated?
The first step in treating any type of tooth wear is to determine the cause during a simple oral examination right here at the dental office. Once the cause has been identified, we can work together to reduce the stresses on your teeth. For example, you may need a refresher course on gentle, effective brushing techniques; or you might benefit from some changes to your diet. If you have a clenching or grinding habit, we can make you a nightguard that will protect your teeth during sleep or periods of high stress. Once we have dealt with the underlying cause, we can make your teeth look beautiful again by replacing lost tooth structure with bonding, veneers, or crowns. This will also allow your bite to function properly again.
Your children’s health is a major concern for you, even before they’re born. That concern should include their dental health and, yes, even before they’re born — a baby’s primary teeth are already forming just a few weeks into pregnancy.
Here, then, are some important tips for keeping your child’s dental health, before and after birth, on track.
Eat healthy during pregnancy. Your baby’s teeth actually begin to mineralize around the third or fourth month of your pregnancy. You can aid this process by eating a diet rich in calcium, phosphorous and protein.
Fight tooth decay by limiting sugar. Sugar is a major contributor to tooth decay, especially in primary teeth. To reduce this risk, limit sugary snacks as much as possible, and avoid bottles filled with sugar-filled liquids (including breast milk) during your baby’s sleeping hours.
Begin good hygiene early. When teeth first appear in the mouth you should begin to wipe around the teeth and gums with a water-soaked gauze pad right after feeding. As teeth develop, begin to gently brush them with a soft-bristled brush with just a smear of fluoridated toothpaste. Teach your child beginning around age 2 to brush for themselves with a pea-sized amount of paste on the brush. By age 6, they should be able to brush on their own and ready to learn flossing.
Schedule regular dental visits and cleanings. Dental checkups should begin around their first birthday and continue semi-annually. Your dentist is a key resource in monitoring tooth development, preventing disease and developing future treatment strategies.
Make your home “tooth-friendly.” Your home environment can be a danger to your child’s mouth. Check for hard or sharp surfaces your child could fall on and eliminate the danger — it’s estimated half of dental injuries to children under seven occur near home furniture. Check your drinking water as well — does your system add fluoride, a proven cavity fighter, or do you need to find other sources?
Taking a few precautions and establishing good life-long dental habits will help ensure your child’s teeth and gums remain healthy right into adulthood.
If you would like more information on oral health for children, 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 “Top 10 Oral Health Tips for Children.”
Are tooth-colored fillings safer than silver fillings?
No. Both are considered safe based on the most reliable and up-to-date scientific evidence. Still, tooth-colored fillings do have some definite advantages. Not only do they blend in with your smile far better than “silver” (dental amalgam) fillings, but they often require less removal of healthy tooth structure. That’s because in order to fill a tooth with amalgam, it is necessary to create indentations in the tooth called “undercuts” to hold the amalgam in; this requires the removal of some healthy tooth material. With a tooth-colored filling, we need only remove the decayed part of the tooth to place the filling.
Are there any disadvantages?
Yes, tooth-colored fillings don’t always wear as well as metal fillings — particularly on back molars where they are subjected to the most stress from chewing. They are also more expensive and less likely to be fully reimbursed under dental insurance plans.
Are there different types of tooth-colored fillings?
Yes, three different choices of tooth-colored fillings are available:
- Composite — This mixture of plastic and glass is the most common type of tooth-colored filling. Newer materials can hold up almost as long as amalgam fillings and look very natural, though they can stain over time just as natural teeth do.
- Porcelain — High-tech dental ceramics are considered the most aesthetic choice of filling material. They don’t stain as composites can, but their relatively high glass content can make them more brittle and prone to breakage. They may be more expensive than composites.
- Glass Ionomer — Made of acrylic and glass powders, these inexpensive, translucent fillings blend in acceptably well with natural teeth and have the advantage of releasing small amounts of fluoride to help prevent decay. However, they generally don’t last as long as other restorative materials.
We would be happy to offer guidance on which choice would be best in your own unique situation.
If you have any questions about tooth-colored fillings, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine article “The Natural Beauty of Tooth-Colored Fillings.”