Posts for: September, 2018
After ruling out other possibilities for your constant jaw joint pain, your doctor has diagnosed you with a temporomandibular disorder (TMD). Now that you know what you have, what can you do about it?
Unfortunately, it's not always an easy answer. Ideas about treatment are almost as numerous as theories on the causes of TMD. By and large, though, we can classify treatment into two broad categories: conservative and aggressive.
The conservative approach is the result of many years of experimentation and application; it's also much less invasive than aggressive treatments. For most patients, though, these treatments can offer significant relief from pain and dysfunction.
Conservative treatments are based primarily on the philosophy that the temporomandibular joint is like any other joint, and should be treated that way. Treatments include thermal therapies like ice or heat packs applied to the jaw, physical therapy (gentle stretching, jaw exercise, and massage) and pain and muscle relaxant medication. In cases where teeth grinding may be a contributing factor, we might recommend a bite guard worn in the mouth to reduce biting pressure.
On the other end of the spectrum are treatments like altering the bite or the position of the jaw. The purpose of bite alteration is to change the dynamic when the jaws are in contact during chewing or clenching, and reduce pressure on the joints. This is often done by reshaping the teeth's biting surfaces, moving the teeth with orthodontics or performing crown and bridgework. Another possibility, actually modifying the lower jaw location, requires surgery. All of these aggressive treatments are done in order of less to more invasiveness.
These more aggressive treatments, especially jaw surgery, are irreversible. Furthermore, studies on results have not been encouraging — there's no guarantee you'll receive relief from your symptoms. You should consider the aggressive approach only as a last resort, after you've tried more conservative measures. Even then, you should get a second opinion before undergoing more invasive procedures.
Hopefully, you'll see relief from therapies that have made a significant difference for most TMD sufferers. And that's our goal: to reduce your pain and dysfunction and help you regain your quality of life.
If you would like more information on TMD causes and treatments, 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 should you do if your child complains about a toothache? Before calling our office, try first to learn what you can about the toothache.
You should first ask them where exactly the pain is coming from — one particular tooth or a generalized, dull ache. Also try to find out, as best they can tell you, when they first noticed the pain. Try then to look at the tooth or area where they indicate the pain is coming from: since tooth decay is a prime cause for tooth pain, you should look for any obvious signs of it like brown spots or cavities. You should also look at the gums around the teeth for any redness or swelling, a sign of an abscess or periodontal (gum) disease.
If you notice any of these signs, the pain persists for more than a day, or it has kept the child awake during the night, you should have us examine them as soon as possible. If you notice facial swelling or they’re running a fever, please call and we will see them immediately. If it’s definitely tooth decay, it won’t go away on its own. The longer we wait to treat it, the worse its effects in the mouth.
In the meantime, you should also try to alleviate the pain as best you can. If when looking in the mouth you noticed food debris (like a piece of hard candy) wedged between the teeth, try to gently remove it with dental floss. Give them ibuprofen or acetaminophen in an appropriate dosage for their age to relieve pain, or apply an ice pack on and off for about 5 minutes at a time to the outside of their jaw.
If any of these remedies stops the pain within an hour, you can wait until the next day to call for an appointment. If the pain persists, though, then an abscess could be developing — you should call that day to see us.
Regardless of when the pain stops, or whether you see any abnormal signs, it’s still important your child see us for an accurate diagnosis. Their toothache maybe trying to tell you something’s wrong — and the earlier a problem is found and treated, the better the outcome.
If you would like more information on dental problems in young 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 “A Child’s Toothache.”
If you’re brushing and flossing daily, as well as seeing your dentist at least every six months, you’re doing the top things needed to maintain your dental health. But all your hygiene efforts could be undermined if you’re not eating a dental-friendly diet. Simply put, there are foods that protect and promote dental health and those that increase your risk of dental disease.
Diets in the latter category are typically high in added sugar and low in natural food fiber. The largest sources of these are processed sugars from sugar cane or beets and high fructose corn syrup. With just a little knowledgeable label reading, you can find sugar and its various aliases added to thousands of processed food items including pastries, candies, sodas and energy drinks.
Heavy consumption of processed sugars also contributes to dental disease. Disease-causing bacteria thrive on sugar as a food source, which fuels both their growth and their production of oral acid. Elevated acid levels can dissolve the minerals in tooth enamel faster than saliva can keep up. Softened enamel opens the door to tooth decay, while increased bacterial growth can lead to periodontal (gum) disease.
A diet, however, low in added sugar and high in fiber can have the opposite effect. Although fresh fruits and vegetables contain natural sugars, they also have indigestible parts called fiber that slow the digestion of any sugars and allow the body to more efficiently process them. With the higher quantity of vitamins and minerals found in unprocessed foods, the overall effect of this diet is a decrease in your risk for dental disease.
Speaking of dental-friendly foods, we should also give honorable mentions to certain dairy items like cheese and milk that stimulate saliva production and are rich in calcium needed for tooth strength. Another beneficial category is both black and green tea, which contain antioxidants to fight disease and fluoride to strengthen enamel.
Adopting a low-sugar/high-fiber diet can have a profound impact on your overall health. Over time, you’ll also reap dental health rewards with stronger teeth and gums and a lower risk of tooth decay and gum disease.
If you would like more information on diet and oral health, 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 “Nutrition & Oral Health.”