Diagnosing jaw problems and pains – TMD and TMJ

More than fifteen percent of American adults suffer from chronic facial pain.

Common symptoms can include pain in or around the ear, tenderness of the jaw, clicking or popping noises when opening the mouth or even head and neck aches.

There are two joints and several jaw muscles which make it possible to open and close the mouth. They work together when you chew, speak, and swallow.

These structures include muscles and ligaments, as well as the jaw bone, the mandible (lower jaw) with two joints, the TMJs.

The TM joint is one of the most complex joints in the body. Located on each side of the head, these joints work together and can make many different movements, including a combination of rotating and gliding action when chewing and speaking.

Several muscles help open and close the mouth. They control the lower jaw (mandible) as it moves forward, backward, and side-to-side.

Both TM joints are involved in these movements. Each TM joint has a disc between the ball and socket. The disc cushions the load while enabling the jaw to open widely and perform rotating and translocational movements.

Any problem that prevents this complex system of muscles, ligaments, discs and bones from working together properly may result in a painful TMJ disorder.

If you are suffering from this type of pain, your dentist can help identify its source with a thorough exam and appropriate x-rays.

Often, the problem is a sinus or toothache or it could be an early stage of periodontal disease.

But for some pain, the cause is not so easily diagnosed.

The pain could be related to the facial muscles, the jaw or temporomandibular joint, located in the front of the ear.

Treatments for this pain may include stress reducing exercises, muscle relaxants, or wearing a mouth protector to prevent teeth grinding.
They’ve been successful for many and your dentist can recommend which is best for you.

How space maintainers help children have healthy teeth

Space maintainers can be crucial to the dental health of a child.

When a child loses a baby tooth early through decay or injury, the other teeth can shift and begin to fill the vacant space.

If this happens, the problem is that, when the permanent teeth emerge, there’s not enough room for them.

This can lead to crooked or crowded teeth and difficulties with chewing or speaking.

To prevent that, the dentist can insert a space maintainer.

This holds the space left by the lost tooth until the permanent tooth emerges.

Space maintainers might be a band or a temporary crown attached to one side of the space.

When the permanent tooth emerges, the dentist removes the device and protects the child’s future smile.

Why its not inevitable that youll lose your teeth as you get older

Advancements in dental techniques and the increased focus on preventive dentistry means older adults are keeping their natural teeth longer than ever before.

A survey by the National Institute of Dental and Craniofacial Research showed that the rate of toothlessness in the 55 to 64 age group has dropped 60 percent since 1960.

Whatever your age, its important to practice good oral hygiene at home and to visit your dentist regularly. A few simple steps can help you maintain good oral health throughout your life.

Plaque, the sticky, colorless layer of bacteria that causes tooth decay and gum disease, can build up quickly on the teeth of older adults, particularly when they neglect oral hygiene. This can increase the risk for tooth decay and periodontal disease.

So its important to brush your teeth twice a day with fluoride toothpaste, and clean between your teeth daily with floss or interdental cleaners.

Regular dental checkups are also an important part of caring for your teeth.

This can help you save your teeth and gums and prevent other dental problems. It will save you time and money in the long-run as well.

How dental x-rays help improve your oral health

Many diseases of the teeth and surrounding tissues cannot be seen when your dentist examines your mouth so an X-ray examination can reveal important additional information:

For example, X-rays can help show:
– Small areas of decay between the teeth or below existing fillings
– Infections in the bone
– Gum disease
– Abscesses or cysts
– Developmental abnormalities
– Some types of tumors

The way they work is that more X-rays are absorbed by the denser parts (such as teeth and bone) than by soft tissues (such as cheeks and gums). This creates an image called a radiograph.

Tooth decay, infections and signs of gum disease appear darker because of more X-ray penetration. The interpretation of these radiographs allows the dentist to safely and accurately detect hidden abnormalities.

The frequency of X-rays (radiographs) will depend on your specific health needs.

Your dentist will review your history, examine your mouth and decide whether you need radiographs and what type.

When you are a new patient, the dentist may recommend radiographs to establish how the hidden areas of your mouth currently look to help identify changes that occur later.

X-rays can help identify and treat dental problems at an early stage and so can save time, money and unnecessary discomfort.

Making the most of your smile

Your smile is a major factor in the impression people get when they meet you.

And the good news is that you now don’t have to settle for a smile spoiled by stained, chipped, or misshapen teeth.

Advances in dental treatment mean there is a wide range of choices to help you get the smile that you want. Here are some of the options:
– Tooth whitening (bleaching) can help brighten teeth that have become discolored or stained. It can be done in the dental office or with a system the dentist can give you to use at home
– Bonding improves the appearance of teeth that have become chipped, broken, cracked or stained. This is done by bonding tooth-colored materials to the tooth surface
– Enamel shaping involves modifying teeth to improve their appearance by removing or contouring enamel
– Veneers are thin custom-made shells of tooth-colored materials designed to cover the front side of teeth. They are used to treat spaces between teeth and teeth that are chipped, stained or poorly shaped.
– Braces may be needed if teeth are crooked, crowded or do not meet properly – and not just for kids

Even small changes can have a big impact on your smile and so make a huge difference to how you look and how you feel about yourself.

If you’d like an even better smile, your dentist will be able to give you information about the options available.

The process of installing Invisalign

Invisalign is a system of clear mouthguards that can be used instead of braces to help straighten teeth.

The big advantage is that Invisalign looks better and is more comfortable than braces.

However, not everyone is a candidate for using the system so you with have to check with your dentist.

If an orthodontist certified in Invisalign says you can benefit from the system, they will take impressions of your mouth, write up a detailed specification and then send everything to a high-tech lab.

Next, the lab will show the orthodontist a preview of the appliances.

The lab then makes a series of aligners – depending on the situation, you may need between 12 to 48 aligners.

After the impression of the teeth is taken, it will normally require a visit to the orthodontist every six weeks.

Some patients will be advised to wear metal braces for a period and then switching to Invisalign when their mouth is ready.

For many people Invisalign provides an ideal way of making their smile look better.

Diabetes and your dental health: How your diet can affect your teeth

When diabetes is not controlled properly, high glucose levels in saliva may create problems that lead to an increased risk of tooth decay.

Your teeth are covered with plaque, a sticky film of bacteria. After you eat food that contains sugars or starches, the bacteria react with these sugars to release acids that attack tooth enamel. This can cause the enamel to break down and may eventually result in cavities.

Brushing twice a day with fluoride toothpaste and cleaning between your teeth with floss or an interdental cleaner helps remove decay-causing plaque.

Plaque that is not removed can eventually harden into calculus, or tartar. When tartar collects above the gumline, it becomes more difficult to clean thoroughly between teeth. This can lead to chronic inflammation and infection in the mouth.

Because diabetes reduces the bodys resistance to infection, the gums are among the tissues likely to be affected.
Periodontal diseases are infections of the gum and bone that hold your teeth in place. Patients with inadequate blood sugar control appear to develop periodontal disease more often and more severely, and they lose more teeth than those who have good control of their diabetes.

Because of the lower resistance and longer healing process, periodontal diseases often appear to be more frequent and more severe among persons with diabetes.

You can help reduce these risks through good maintenance of blood sugar levels, a well-balanced diet, good oral care at home and regular dental checkups.

Understanding your wisdom teeth

Many patients ask whether wisdom teeth are really necessary since so many people have them removed.

The fact is that wisdom teeth are a valuable asset to the mouth when they are healthy and properly positioned.

However, problems can occur that sometimes make it better to have them removed.

For example, when the jaw isn’t large enough, the wisdom teeth can become impacted – misaligned or unable to grow in properly. They may grow sideways, emerge only part way from the gum or remain trapped beneath the gum and bone.

The reasons wisdom teeth may have to be extracted include:
– The teeth have only partially erupted. This leaves an opening for bacteria which cause infection.
– There is a chance the wisdom teeth will damage adjacent teeth.
– A cyst forms which may destroy surrounding structures such as bone or tooth roots.

Ask your dentist about the health and positioning of your wisdom teeth.

Your dentist will tell you if there are any issues and will recommend any steps needed.

Some tips on overcoming nerves when going to the dentist

Some people get a bit nervous about the idea of going to the dentist.

As a result of the major progress that has been made in diagnosis and treatment, the process gets more comfortable all the time. So you may be worrying unnecessarily.

But, if you’re in any way tense or anxious, tell your dentist and the dental staff.

They will understand and will be able to adapt the treatment to your needs.

It can also help if you choose a time for your dental visit when you’re less likely to be rushed or under pressure. Dashing out from a busy day at work may make you feel more stressed.

For many people, that means making an early-morning or a Saturday appointment helps a great deal.

There are also other steps than can help. If the sound of the drill bothers you, take a portable audio player and headset so you can listen to your favorite music.

You can also help to relax by simply visualizing yourself somewhere you feel relaxed.

Sometimes these simple steps can help you feel a lot better. So why not give it a try on your next visit?

How cancer treatment affects oral health

When someone is undergoing cancer treatment, its important that they involve their dentist in their program of care.

They should schedule a dental exam and cleaning before the treatment actually begins and then repeat it periodically during the course of treatment.

Its important that they tell the dentist that they are being treated for cancer and that they also discuss any dental procedures, such as extractions or insertion of dental implants, with the oncologist before starting the cancer treatment.

Its therefore a good idea to ensure that the dentist and oncologist have each others details to enable them to discuss any issues to help the patient.

And the dentist and physician should be informed about any issues such as bleeding of the gums, pain, or unusual feeling in the teeth or gums, or any dental infections.

Maintaining excellent oral hygiene during cancer treatment is vital to reduce the risk of infection and to help aid the treatment process. 

Why your routine dental cleaning is not routine

For many patients, the dental cleaning appointment may seem little more than a more complicated version of brushing your teeth.

However, this appoinment plays a crucial role in patient education and prevention of dental disease.

The appointment is called a dental prophylaxis, or prophy and it’s one of the most important steps in your dental care program.

Here are some of the elements that it may include, depending on your needs:

– Oral hygiene evaluation

– Tooth brushing and flossing instructions

– Scaling above the gum to remove plaque and tartar

– Debridement of tartar beneath the gum

– Polishing the teeth

– Periodontal charting

It’s important to remove plaque from the teeth as it ultimately forms a hard, rough sediment known as tartar or calculus, which must be removed by a dental professional to help prevent periodontal disease.

Polishing the teeth removes stains and creates a feeling of fresh breath and a clean mouth.

The hygienist or dentist may recommend a prophylaxis visit every two to six months.

Although insurance may only cover two prophies a year, recall frequency depends on many factors and should be based on individual needs.

These appointments can help you have much better dental health and could save you a great deal of time and money in the long run.

Caring for people who have special needs

People at any age can have a condition that makes it difficult for them to look after their own dental health.

This could affect people who suffer from a wide range of conditons such as stroke, spinal cord injury, multiple sclerosis, mental retardation, Down syndrome, genetic disorders, Alzheimers disease or arthritis.

However, people in all of these categories have the same dental needs as everyone else – they need daily brushing and flossing, regular dental visits and a balanced diet.

There are some steps caregivers can take to make it easier to look after people in those categories.

If the person is uncooperative or uncontrollable, try to explain what you are about to do and schedule the task for a time of day when they are rested.

Move in a calm, slow, reassuring manner to avoid startling them. Give praise and encourage them when they help themselves.

Support the persons head, and take special care to prevent choking or gagging when the head is tilted back.

If the person is unable or unwilling to keep their mouth open, your dentist will explain how you can make and use a mouth prop.

Ask your dentist for advice on how to care for people with special needs and check if they have facilities for caring for these needs in the dental office.

Is it safe to have an X-ray while pregnant?

Some women worry about whether its safe to have an X-ray exam while they are pregnant.

This can cause them to put off treatment they need.

However, untreated dental infections can pose a risk to the fetus, and dental treatment may be necessary to maintain the health of the mother and child. Sometimes this will mean an X-ray is necessary.

Radiation from dental X-rays is extremely low but every precaution is taken to minimize radiation exposure.

For example, a leaded apron reduces exposure to the abdomen and should be used when a dental radiograph is taken.

In addition, a leaded thyroid collar can protect the thyroid from radiation, and should be used whenever possible. The use of a leaded thyroid collar is strongly recommended for women of childbearing age, pregnant women and children.

Overall there is no reason to avoid dental radiographs (X-rays) while pregnant, breastfeeding or trying to become pregnant.

Follow your dentists advice and ask questions if you have any concerns.

How to take care of your teeth with braces

Braces are orthodontic apparatus used to help fix crooked and crowded teeth.

While modern braces can be comfortable and inconspicuous, you may have to take extra steps to care for your teeth when wearing them.

Its important that you continue good oral hygiene practices while wearing braces.

You need to continue brushing regularly, following the approach suggested by your dentist, as well as flossing daily and making regular visits to the dentist.

People with braces should stick to a balanced diet and limit the number of snacks between meals.

Your dentist may suggest that you avoid certain foods that could interfere with braces or accidentally bend the wires. This can include nuts, popcorn, hard candy, ice and sticky foods such as chewing gum or caramel.

You can still continue to enjoy sports and other activities but a protective mouth guard is often recommended to reduce the risk of injury to the mouth or jaw. Your dentist will suggest an appropriate mouth guard when the braces are in place.

Braces can make a big difference to your smile and your future dental health. Modern technology and following good practices means you should be able to wear them with comfort and confidence.

Different types of fillings and restorations

Nowadays, thanks to advances in dental techniques and materials, patients have a much wider range of choices when they have to repair missing, worn, damaged or decayed teeth.

For example, materials such as ceramics and polymer compounds that look more like natural teeth help dentists create pleasing, natural-looking smiles.

The traditional materials such as gold, base metal alloys and dental amalgam are still widely used as they have many advantages.

The strength and durability of traditional dental materials continues to make them useful in many situations. For example, they are good when fillings are required in the back teeth because the pressure of chewing is high in that area.

The choice of the best option will depend on several factors such as the patient’s oral and general health, where and how the filling is placed and the number of visits needed to prepare and adjust the restored tooth.

The choice about which option is best depends on each individuals needs so you should discuss the options with your dentist.

Taking care of your dentures

Your dentures are designed to last a very long time so its important that you take care of them as you would take care of your own teeth.

They are very delicate and may break easily if dropped even a few inches. So its a good idea to stand over a folded towel or a basin of water when handling dentures.

When you are not wearing your dentures, store them away from children and pets.

Like natural teeth, dentures must be brushed daily to remove food deposits and plaque.

Brushing helps prevent dentures from becoming permanently stained and helps your mouth stay healthy.

There are special brushes designed for cleaning dentures but a toothbrush with soft bristles can also be used. Avoid using hard-bristled brushes as these can damage your dentures.

Some denture wearers also use hand soap or mild dishwashing liquid for cleaning and thats fine. But avoid using powdered household cleansers, which may be too abrasive. Also, avoid using bleach, as this may whiten the pink portion of the denture.

The first step in cleaning dentures is to rinse away loose food particles thoroughly. Moisten the brush and apply denture cleanser. Brush every surface, scrubbing gently to avoid damage.

Dentures may lose their shape if they are allowed to dry out. When they are not worn, dentures should be placed in a denture cleanser soaking solution or in water. Never place dentures in hot water, which could cause them to warp.

Ultrasonic cleaners are also used to care for dentures. However, using an ultrasonic cleaner does not replace a thorough daily brushing.

You can seriously damage your dentures by trying to adjust or repair them yourself. So see your dentist if your dentures break, crack, chip or if one of the teeth becomes loose.

Over time, dentures will need to be relined, rebased, or remade due to normal wear. They may also need to be replaced if they become loose and the teeth show signs of significant wear.

You need to make regular visits to your dentist to make sure the dentures are working as well as possible for you and to check for more serious problems in your mouth such as oral cancer.

The risks of oral piercing

Young people today choose to make a variety of fashion statements affecting not just the clothes they wear but also their bodies through tattoos and piercing, for example.

Oral piercing may be something they feel looks good but it can lead to problems where they end up needing medical or dental treatment.

Oral piercing can often lead to symptoms such as pain, swelling, infection, increased saliva flow and injuries to the gum tissue.

There can be severe bleeding if a blood vessel is in the path of the needle during the piercing.

Swelling of the tongue is also a common side effect and, in extreme cases, this can block the airway and lead to breathing difficulties.

Other possible problems include chipped or cracked teeth, blood poisoning or even blood clots.

Infection is a very common complication of oral piercing because of the millions of bacteria in your mouth.

Of course, the jewelry itself also causes risk. It can be swallowed or cause damage to your teeth.

So, while young people may feel piercings in the mouth look cool, a great smile will look a lot better in the years to come.

The early years of dentistry and teeth

Although there have been huge advances in dental care in recent years, there are records of people dealing with teeth going back over thousands of years.

Here are some of the key dates from the early years in the development of dentistry.

5000 BC: A Sumerian text describes tooth worms as the cause of dental decay.

2600 BC: Hesy-Re, an Egyptian scribe, often called the first dentist, dies. An inscription on his tomb includes the title the greatest of those who deal with teeth, and of physicians.

500-300 BC: Hippocrates and Aristotle write about dentistry, including the eruption pattern of teeth, treating decayed teeth and gum disease, extracting teeth with forceps, and using wires to stabilize loose teeth and fractured jaws.

166-201 AD: The Etruscans practice dental prosthetics using gold crowns and fixed bridgework.

500-1000: During the Early Middle Ages in Europe, medicine, surgery, and dentistry, are generally practiced by monks, the most educated people of the period

700: A medical text in China mentions the use of silver paste, a type of amalgam.

1130-1163: A series of Papal edicts prohibit monks from performing any type of surgery, bloodletting or tooth extraction. Barbers often assisted monks in their surgical ministry because they visited monasteries to shave the heads of monks and the tools of the barber trade sharp knives and razors were useful for surgery. Following the edicts, barbers assume the monks surgical duties: bloodletting, lancing abscesses, extracting teeth, etc.

1210: A Guild of Barbers is established in France. Barbers eventually evolve into two groups: surgeons who were educated and trained to perform complex surgical operations; and lay barbers, or barber-surgeons, who performed more routine hygienic services including shaving, bleeding and tooth extraction.

1400s: A series of royal decrees in France prohibit lay barbers from practicing all surgical procedures except bleeding, cupping, leeching, and extracting teeth.

Why dry mouth can be a problem and what to do about it

Your saliva plays an important role in your oral health and reduced saliva flow can lead to health problems.

Reduced saliva flow can lead to a dry mouth and this is a common problem among older adults.

It can be caused by various medical disorders and is often a side effect of medications such as antihistamines, decongestants, pain killers and diuretics.

Dry mouth can be associated with various problems such as a constant sore throat, burning sensation, problems speaking, difficulty swallowing, hoarseness or dry nasal passages.

Drying irritates the soft tissues in the mouth, which can make them inflamed and more susceptible to infection. Without the cleansing effects of saliva, tooth decay and other oral health problems become more common.

So, if dry mouth is not treated, it can damage your teeth.

Without adequate saliva to lubricate your mouth, wash away food, and neutralize the acids produced by plaque, extensive decay can occur.

Your dentist can recommend various methods to restore moisture. Sugar-free candy or gum stimulates saliva flow, and moisture can be replaced by using artificial saliva and oral rinses.

Different types of dentist and how they help your oral care

While many people see dentists as the single group of people who look after the health of your teeth and mouth, there are various specialist categories that help you in different ways.

The categorization of a dentist will depend on their education, training and experience.

Here are some of the main specialist areas of dentistry:

Endodontics: Concerned with the dental pulp – the part in the center of a tooth made up of living soft tissue and cells and root canal therapy

Oral and Maxillofacial Pathology: This deals with the identification, and management of diseases affecting the oral and maxillofacial regions

Oral and Maxillofacial Radiology: Deals with the production and interpretation of images and data produced by radiant energy that are used for the diagnosis and management of diseases, disorders and conditions of the oral and maxillofacial region

Oral and Maxillofacial Surgery: Diagnosis and surgical treatment of diseases, injuries and defects of the tissues including extractions, facial surgery and implants

Orthodontics and Dentofacial Orthopaedics: Mainly deals with diagnosis, prevention and treatment of misaligned teeth and modification of midface and mandibular growth

Pediatric Dentistry: Provides preventive and therapeutic oral health care for infants and children through adolescence.

Periodontics: Prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth and the maintenance of the health, function and esthetics of these structures and tissues. Most periodonitist place implants

Prosthodontics: Diagnosis, treatment planning, rehabilitation and maintenance associated with missing or deficient teeth and/or oral and maxillofacial tissues. Includes dentures, bridges and the restoration of implants.

Plus, of course, general dentists provide everyday care and many specialist services to maintain your oral health.