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.”
Perhaps you haven’t thought of it quite this way, but saliva is one of the true wonders of the human body. This unassuming fluid performs a variety of tasks to aid digestion and help protect your mouth from disease. And you hardly notice it — except when it’s not there.
That’s the case for millions of people in America who have a chronic condition called xerostomia or “dry mouth.” This happens when the salivary glands don’t secrete enough saliva, normally two to four pints daily.
Of course, we can experience mouth dryness when we first wake up (saliva flow ebbs while we sleep), feel stressed, use tobacco, or consume alcohol and certain foods like onions or spices. It becomes a problem, though, when periods of low saliva become chronic. Without its preventive capabilities, you’ll be at much higher risk for dental diseases like tooth decay or periodontal (gum) disease.
Chronic dry mouth can occur for various reasons: systemic diseases like cancer or autoimmune deficiencies can cause it, as well as radiation or chemotherapy treatments. One of the most common causes, though, is medication, both over-the-counter and prescription. The surgeon general identifies over 500 known drugs that may inhibit saliva production, including some antihistamines, diuretics and antidepressants. It’s often why older people who take more medications than younger people suffer more as a population from dry mouth.
Because of its long-term health effects, it’s important to try to boost saliva flow. If your mouth is consistently dry, try to drink more fluids during the day. If you suspect your medication, see if your physician can prescribe a different drug. It also helps to drink a little water before and after taking oral medication.
We may also recommend medication or other substances that stimulate saliva or temporarily substitute for it. Xylitol, a natural alcohol sugar that also inhibits bacterial growth, can help relieve dryness. You’ll often find it in gums or mints.
Chronic dry mouth is more than a minor irritation — it can lead to more serious conditions. In addition to these tips, be sure to also keep up your regular dental visits and maintain a daily schedule of oral hygiene to prevent dental disease.
If you would like more information on overcoming dry mouth, 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 “Dry Mouth: Learn about the Causes and Treatment of this Common Problem.”
For anyone else, having a tooth accidentally knocked out while practicing a dance routine would be a very big deal. But not for Dancing With The Stars contestant Noah Galloway. Galloway, an Iraq War veteran and a double amputee, took a kick to the face from his partner during a recent practice session, which knocked out a front tooth. As his horrified partner looked on, Galloway picked the missing tooth up from the floor, rinsed out his mouth, and quickly assessed his injury. “No big deal,” he told a cameraman capturing the scene.
Of course, not everyone would have the training — or the presence of mind — to do what Galloway did in that situation. But if you’re facing a serious dental trauma, such as a knocked out tooth, minutes count. Would you know what to do under those circumstances? Here’s a basic guide.
If a permanent tooth is completely knocked out of its socket, you need to act quickly. Once the injured person is stable, recover the tooth and gently clean it with water — but avoid grasping it by its roots! Next, if possible, place the tooth back in its socket in the jaw, making sure it is facing the correct way. Hold it in place with a damp cloth or gauze, and rush to the dental office, or to the emergency room if it’s after hours or if there appear to be other injuries.
If it isn’t possible to put the tooth back, you can place it between the cheek and gum, or in a plastic bag with the patient’s saliva, or in the special tooth-preserving liquid found in some first-aid kits. Either way, the sooner medical attention is received, the better the chances that the tooth can be saved.
When a tooth is loosened or displaced but not knocked out, you should receive dental attention within six hours of the accident. In the meantime, you can rinse the mouth with water and take over-the-counter anti-inflammatory medication (such as ibuprofen) to ease pain. A cold pack temporarily applied to the outside of the face can also help relieve discomfort.
When teeth are broken or chipped, you have up to 12 hours to get dental treatment.Â Follow the guidelines above for pain relief, but don’t forget to come in to the office even if the pain isn’t severe. Of course, if you experience bleeding that can’t be controlled after five minutes, dizziness, loss of consciousness or intense pain, seek emergency medical help right away.
And as for Noah Galloway:Â In an interview a few days later, he showed off his new smile, with the temporary bridge his dentist provided… and he even continued to dance with the same partner!
If you would like more information about dental trauma, please contact us or schedule an appointment for a consultation. You can learn more in the Dear Doctor magazine articles “Trauma & Nerve Damage to Teeth” and “The Field-Side Guide to Dental Injuries.”
Confused about which toothpaste to buy? You’re not alone — we’re all regularly confronted with multiple choices when we shop.
But you can simplify your decision-making process by first remembering that toothpaste has one main objective: helping to break down and remove dental plaque when you brush. Plaque is a thin film of bacteria and food particles that if you don’t remove through brushing and flossing could trigger tooth decay or periodontal (gum) disease.
Toothpastes contain abrasives and detergents to help make this possible. Abrasives like hydrated silica are gritty substances that work with the mechanical brushing action to loosen plaque. Detergents (usually sodium lauryl sulfate) help loosen and break down particles on your teeth that won’t otherwise dissolve with water alone. The combination of these ingredients and daily brushing action enables you to remove a substantial portion of plaque from your teeth every day.
These ingredients (along with others to retain moisture and bind everything together) are the foundation of any toothpaste. There are other additives, however, that you may also want to consider. The most important is fluoride, a naturally-occurring chemical proven to strengthen enamel against tooth decay. If you’re interested in a brighter smile, you can also look for bleaching agents that may help whiten some enamel staining. And, of course, there are various flavors to suit your taste.
You’ll also want to pay attention to ingredients if you have special concerns. If you have sensitive teeth, your dentist may recommend particular brands that help reduce discomfort. You’ll also want to be on the lookout for ingredients that you may be allergic to like the aforementioned sodium lauryl sulfate or flavors like cinnamon. Be sure to read the ingredients label if you have known issues with certain substances.
And while you’re reading the packaging look for one more thing — the American Dental Association Seal of Approval. This seal means any manufacturer claims for lower occurrences of cavities or other effects by that toothpaste have been independently verified.
It can be overwhelming amid all the product messaging to decide which toothpaste is right for you. But by knowing these basic facts about toothpaste, you can feel more confident choosing the right one to help keep your teeth and gums clean and healthy.
If you would like more information on oral hygiene products, 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 “Toothpaste: What’s in it?”
Mayim Bialik has spent a good part of her life in front of TV cameras: first as the child star of the hit comedy series Blossom, and more recently as Sheldon Cooper’s love interest — a nerdy neuroscientist — on The Big Bang Theory. (In between, she actually earned a PhD in neuroscience from UCLA…but that’s another story.) As a child, Bialik had a serious overbite — but with all her time on camera, braces were just not an option.
“I never had braces,” she recently told Dear Doctor – Dentistry & Oral Health magazine. “I was on TV at the time, and there weren’t a lot of creative solutions for kids who were on TV.” Instead, her orthodontist managed to straighten her teeth using retainers and headgear worn only at night.
Today, there are several virtually invisible options available to fix orthodontic issues — and you don’t have to be a child star to take advantage of them. In fact, both children and adults can benefit from these unobtrusive appliances.
Tooth colored braces are just like traditional metal braces, with one big difference: The brackets attached to teeth are made from a ceramic material that blends in with the natural color of teeth. All that’s visible is the thin archwire that runs horizontally across the teeth — and from a distance it’s hard to notice. Celebs like Tom Cruise and Faith Hill opted for this type of appliance.
Clear aligners are custom-made plastic trays that fit over the teeth. Each one, worn for about two weeks, moves the teeth just a bit; after several months, you’ll see a big change for the better in your smile. Best of all, clear aligners are virtually impossible to notice while you’re wearing them — which you’ll need to do for 22 hours each day. But you can remove them to eat, or for special occasions. Zac Efron and Katherine Heigl, among others, chose to wear clear aligners.
Lingual braces really are invisible. That’s because they go behind your teeth (on the tongue side), where they can’t be seen; otherwise they are similar to traditional metal braces. Lingual braces are placed on teeth differently, and wearing them often takes some getting used to at first. But those trade-offs are worth it for plenty of people. Which celebs wore lingual braces? Rumor has it that the list includes some top models, a well-known pop singer, and at least one British royal.
So what’s the best way to straighten your teeth and keep the orthodontic appliances unnoticeable? Just ask us! We’d be happy to help you choose the option that’s just right for you. You’ll get an individualized evaluation, a solution that fits your lifestyle — and a great-looking smile!
For more information about hard-to-see (or truly invisible) orthodontics, please contact our office or schedule a consultation. You can read more in the Dear Doctor magazine articles “Orthodontics for the Older Adult” and “Clear Aligners for Teenagers.”
This website includes materials that are protected by copyright, or other proprietary rights. Transmission or reproduction of protected items beyond that allowed by fair use, as defined in the copyright laws, requires the written permission of the copyright owners.