Posts for: June, 2018
Chronic jaw pain can make eating, speaking or even smiling difficult. What's more, finding the right treatment approach can be just as difficult.
This is because TMD (Temporomandibular Disorder: named for the joints on either side of the lower jaw) actually describes a wide range of possible problems with the joints and connecting muscles. Any of them can result in impaired jaw function, radiating pain or even headaches.
We'll need to conduct a full dental and facial exam to accurately diagnose your jaw pain's cause. Even then, the way may still not be clear: there's considerable debate among dentists about the best treatment approach. Two basic schools of thought prevail, one conservative and non-invasive and the other more aggressive and interventional.
The conservative approach seeks to alleviate symptoms in a variety of ways, including recommending softer foods to give muscles and joints time to relax, applying cold and heat to ease soreness, massage of the jaw joint muscles, gentle stretching and jaw exercises. We may also prescribe medications like ibuprofen and other non-steroidal anti-inflammatory drugs for pain and swelling relief, and sometimes muscle relaxers to reduce spasms. If your pain stems from clenching or grinding habits, we could fit you with a custom bite guard you wear while you sleep to reduce the forces on your teeth.
The more aggressive approach is much more invasive. These methods include altering the bite or teeth position with orthodontics or dental work or surgically altering the joints themselves or the shape of the jaw. If you're recommended one of these more aggressive treatments, you should know they're not commonly used to treat TMD and they're irreversible. There's also no guarantee you'll gain relief from your symptoms, so by all means get a second opinion before undergoing any procedures.
For most people the best course of treatment is to start with the least invasive techniques, which are usually very successful. If they don't relieve your pain and limited function, we may then consider escalating treatment to more irreversible procedures to help you find relief from this unwelcome condition.
If you would like more information on jaw joint pain and how to treat it, 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.”
There's a burning sensation in your mouth even though you haven't had anything hot to eat or drink. It's an experience you've had for years, often accompanied by mouth dryness, tingling or numbness that leaves you irritable, anxious or depressed.
The root causes for Burning Mouth Syndrome (BMS) remain elusive, although there appear to be links to diabetes, acid reflux, menopausal hormonal changes or even psychological issues. Although we may not be able to pinpoint the root cause we can identify contributing factors to BMS through a detailed oral examination and medical history (including drugs you're taking).
Mouth dryness is one of the most common factors for BMS. The lack of lubrication from adequate saliva flow can contribute substantially to the irritating burning sensation. There are a number of causes for mouth dryness, including as a side effect from many medications or other treatments.
We must also consider whether an allergic reaction — the body's over-reaction to a foreign substance — may have a role in your symptoms. Some people react to sodium lauryl sulfate, a foaming agent found in many types of toothpaste, along with whitening substances or flavorings like cinnamon; denture wearers can become allergic to the plastic materials used to construct the denture. These, as well as spicy foods, smoking or alcohol, can irritate or cause the tissues lining the inside of the mouth to peel.
Determining what factors contribute to your symptoms allows us to develop a treatment approach tailored to your situation. If, for example, we've determined your BMS stems from dry mouth as a side effect to medication, we can ask your doctor to prescribe an alternative, increase your water intake when taking pills or stimulate saliva flow. If we identify an allergen as a factor, you can eliminate the substance to reduce symptoms.
You may also need to make changes to your eating and lifestyle habits: stop smoking, reduce your alcohol or coffee consumption and avoid very hot or spicy foods. And look for ways to reduce stress, another contributing factor, through relaxation techniques, exercise or support groups.
It's possible that BMS will resolve itself over time. In the meantime, though, we can help you find ways to alleviate the irritation.
If you would like more information on diagnosing and treating BMS, 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.”
While the sport of golf may not look too dangerous from the sidelines, players know it can sometimes lead to mishaps. There are accidents involving golf carts and clubs, painful muscle and back injuries, and even the threat of lightning strikes on the greens. Yet it wasn’t any of these things that caused professional golfer Danielle Kang’s broken tooth on the opening day of the LPGA Singapore tournament.
“I was eating and it broke,” explained Kang. “My dentist told me, I've chipped another one before, and he said, you don't break it at that moment. It's been broken and it just chips off.” Fortunately, the winner of the 2017 Women’s PGA championship got immediate dental treatment, and went right back on the course to play a solid round, shooting 68.
Kang’s unlucky “chip shot” is far from a rare occurrence. In fact, chipped, fractured and broken teeth are among the most common dental injuries. The cause can be crunching too hard on a piece of ice or hard candy, a sudden accident or a blow to the face, or a tooth that’s weakened by decay or repetitive stress from a habit like nail biting. Feeling a broken tooth in your mouth can cause surprise and worry—but luckily, dentists have many ways of restoring the tooth’s appearance and function.
Exactly how a broken tooth is treated depends on how much of its structure is missing, and whether the soft tissue deep inside of it has been compromised. When a fracture exposes the tooth’s soft pulp it can easily become infected, which may lead to serious problems. In this situation, a root canal or extraction will likely be needed. This involves carefully removing the infected pulp tissue and disinfecting and sealing the “canals” (hollow spaces inside the tooth) to prevent further infection. The tooth can then be restored, often with a crown (cap) to replace the entire visible part. A timely root canal procedure can often save a tooth that would otherwise need to be extracted (removed).
For less serious chips, dental veneers may be an option. Made of durable and lifelike porcelain, veneers are translucent shells that go over the front surfaces of teeth. They can cover minor to moderate chips and cracks, and even correct size and spacing irregularities and discoloration. Veneers can be custom-made in a dental laboratory from a model of your teeth, and are cemented to teeth for a long-lasting and natural-looking restoration.
Minor chips can often be remedied via dental bonding. Here, layers of tooth-colored resin are applied to the surfaces being restored. The resin is shaped to fill in the missing structure and hardened by a special light. While not as long-lasting as other restoration methods, bonding is a relatively simple and inexpensive technique that can often be completed in just one office visit.
If you have questions about restoring chipped teeth, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Porcelain Veneers” and “Artistic Repair of Chipped Teeth With Composite Resin.”