Chronic jaw pain and limited jaw mobility are two common symptoms of a group of conditions known as temporomandibular joint disorders (TMJD or TMD). Several effective treatments have developed over the years, despite the fact that the underlying causes for TMD remain an elusive quarry for medical researchers.
But we may now have a promising new lead in understanding TMD: a possible link between it and other systemic inflammatory diseases. In recent study researchers interviewed over 1,500 people with TMD about various aspects of their lives. Nearly two-thirds reported at least three or more other inflammatory health conditions like fibromyalgia, chronic headaches or rheumatoid arthritis.
These statistics suggest a relationship between TMD and these other conditions. Further exploration of these possible links could result not only in a greater understanding of TMD but better treatment strategies for it and the other related conditions.
In the meantime, though, what can you do if you're currently dealing with TMD?
As of now the approaches with the best results continue to be conservative, non-invasive techniques we've used for several years. Thermal therapies like hot or cold compresses to the jaw area, for example, are quite effective in providing pain relief, and muscle relaxant drugs have proven beneficial for improving jaw mobility.
More radical approaches like jaw surgery have also come into prominence. But there's a caveat here: a significant number of people find their conditions don't improve or may even worsen. In the study previously mentioned, only 38% of respondents who had undergone jaw surgery saw any range of improvement (from slight to significant); by contrast, 28% indicated no change in symptoms and 46% said they were worse off.
It's important, then, that you thoroughly discuss your condition with your dentist, verifying first that you have TMD.Â Together you can develop a treatment plan to relieve pain and restore jaw function. If your dentist or surgeon suggests surgery, consider seeking a second opinion before choosing this more radical approach.
Hopefully, further research into the causes and relationships of TMD with other health conditions will yield still better treatments. In the meantime, you may still find relief and improve your quality of life with the proven techniques available now.
If you would like more information on treatments for chronic jaw pain, 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 “Chronic Jaw Pain and Associated Conditions.”
Ever since childhood, when her career as a model and actress took off, Brooke Shields has enjoyed worldwide recognition — through advertisements for designer jeans, appearances on The Muppet Show, and starring roles in big-screen films. But not long ago, that familiar face was spotted in an unusual place: wearing a nasal anesthesia mask at the dentist's office. In fact, Shields posted the photo to her own Instagram account, with the caption “More dental surgery! I grind my teeth!” And judging by the number of comments the post received, she's far from alone.
In fact, researchers estimate that around one in ten adults have dental issues that stem from teeth grinding, which is also called bruxism. (Many children also grind their teeth, but it rarely causes serious problems, and is often outgrown.) About half of the people who are teeth grinders report problems like persistent headaches, jaw tenderness and sore teeth. Bruxism may also result in excessive tooth wear, and may damage dental work like crowns and bridges; in severe cases, loosened or fractured teeth have been reported.
Researchers have been studying teeth grinding for many years; their findings seem to indicate that it has no single cause. However, there are a number of factors that play a significant role in this condition. One is the anatomy of the jaw itself, and the effect of worn or misaligned teeth on the bite. Another factor relates to changes in brain activity that occur during the sleep cycle. In fact, nocturnal (nighttime) bruxism is now classified as a sleep-related movement disorder. Still other factors, such as the use of tobacco, alcohol and drugs, and a high level of stress or anxiety, can make an individual more likely to experience bruxism.
What can be done for people whose teeth grinding is causing problems? Since this condition may have many causes, a number of different treatments are available. Successful management of bruxism often begins by striving to eliminate the factors that may cause problems — for example, making lifestyle changes to improve your health, creating a soothing nighttime environment, and trying stress-reduction techniques; these may include anything from warm baths and soft music at bedtime, to meditation and mindfulness exercises.
Several dental treatments are also available, including a custom-made occlusal guard (night guard) that can keep your teeth from being damaged by grinding. In some cases, a bite adjustment may also be recommended: In this procedure, a small amount of enamel is removed from a tooth to change the way it contacts the opposite tooth, thereby lessening the biting force on it. More invasive techniques (such as surgery) are rarely needed.
A little tooth grinding once in a while can be a normal response to stress; in fact, becoming aware of the condition is often the first step to controlling it. But if you begin to notice issues that could stem from bruxism — or if the loud grinding sounds cause problems for your sleeping partner — it may be time to contact us or schedule an appointment. You can read more about bruxism in the Dear Doctor magazine article “Stress and Tooth Habits.”
We’ve waged war for decades against tooth decay through oral hygiene and the increasing use of fluoride, nature’s “super weapon” against this disease. And yet, tooth decay remains a significant health problem.
One major reason is refined sugar found in many processed foods. In the 1970s researchers raised concerns about the fat content of many processed foods, so manufacturers began removing fat from their products — along with much of the flavor. To compensate, they added sugar. Today, three-quarters of approximately 600,000 food products contain sugar.
This has increased average individual consumption to 90 pounds of sugar annually. The World Health Organization says we should consume no more than 20 pounds annually, or about 6 teaspoons a day. A single can of soda contains 4 teaspoons, two-thirds of the daily allowance.
High sugar consumption is an obvious threat to dental health: decay-causing bacteria thrive on it. But the trend has also been linked to serious health problems like diabetes and heart disease.
Hopefully, changes in public policy will one day modify the addition of sugar in processed foods. In the meantime, you can take action for yourself and your family to create a more healthy relationship with this popular carbohydrate.
Shop wisely. Learn to read and understand food labels: steer clear of those containing sugar or large numbers of ingredients. Become acquainted with sugar’s many other “names” like corn syrup or evaporated cane juice. And maximize your shopping on a store’s outer perimeters where you’ll find fresh fruits, vegetables and dairy products, rather than the middle aisles with “boxed” processed items.
Avoid sugar-added drinks. Limit consumption of sodas, sports drinks, sweet teas or even juice to avoid added sugar. Make water or sugar-free beverages your go-to drinks. It’s much better to eat sugar naturally found in fresh fruits and vegetables, where fiber helps slow it’s absorption in the body, than to drink it.
Exercise. Depending on your condition, physical exertion is good for your overall health. It’s especially beneficial for your body’s ability to metabolize sugar. So with your doctor’s advice, exert your body every day.
It’s important to engender a proper relationship with sugar — a little can go a long way. Putting sugar in its rightful place can help you avoid tooth decay and increase your chances of greater overall health.
If you would like more information on sugar’s impact on dental and general 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 “The Bitter Truth About Sugar.”
Did you see the move Cast Away starring Tom Hanks? If so, you probably remember the scene where Hanks, stranded on a remote island, knocks out his own abscessed tooth — with an ice skate, no less — to stop the pain. Recently, Dear Doctor TV interviewed Gary Archer, the dental technician who created that special effect and many others.
“They wanted to have an abscess above the tooth with all sorts of gunk and pus and stuff coming out of it,” Archer explained. “I met with Tom and I took impressions [of his mouth] and we came up with this wonderful little piece. It just slipped over his own natural teeth.” The actor could flick it out with his lower tooth when the time was right during the scene. It ended up looking so real that, as Archer said, “it was not for the easily squeamish!”
That’s for sure. But neither is a real abscess, which is an infection that becomes sealed off beneath the gum line. An abscess may result from a trapped piece of food, uncontrolled periodontal (gum) disease, or even an infection deep inside a tooth that has spread to adjacent periodontal tissues. In any case, the condition can cause intense pain due to the pressure that builds up in the pus-filled sac. Prompt treatment is required to relieve the pain, keep the infection from spreading to other areas of the face (or even elsewhere in the body), and prevent tooth loss.
Treatment involves draining the abscess, which usually stops the pain immediately, and then controlling the infection and removing its cause. This may require antibiotics and any of several in-office dental procedures, including gum surgery, a root canal, or a tooth extraction. But if you do have a tooth that can’t be saved, we promise we won’t remove it with an ice skate!
The best way to prevent an abscess from forming in the first place is to practice conscientious oral hygiene. By brushing your teeth twice each day for two minutes, and flossing at least once a day, you will go a long way towards keeping harmful oral bacteria from thriving in your mouth.
If you have any questions about gum disease or abscesses, please contact us or schedule an appointment for a consultation. You can learn more by reading the Dear Doctor magazine articles “Periodontal (Gum) Abscesses” and “Confusing Tooth Pain.”
The market for sugar alternatives has grown exponentially since saccharin was accidentally discovered in 1878. Today, saccharin has been joined by other FDA-approved zero-calorie artificial sweeteners, including aspartame (“Equal®” or “NutraSweet®”), sucralose (“Splenda®”) and rebaudioside A, derived from the stevia plant. You can also choose low-calorie alcohol sugars like erythritol or xylitol.
With rare exceptions, all these choices are widely considered safe substitutes for table sugar, high fructose corn syrup or other versions of this plentiful carbohydrate. Finding substitutes for sugar is a worthy health goal: besides its role in obesity, sugar is considered a contributing factor in cardiovascular disease and diabetes.
It's also a prime food for oral bacteria that cause dental disease. As bacteria consume sugar they produce acid as a byproduct. Acid softens and dissolves the mineral content in enamel, leading to erosion and the formation of cavities. While saliva normally neutralizes acid after we eat, constant snacking and higher quantities of sugar in our food make it difficult for it to control or neutralize acid in the oral environment.
Because most of us are hard-wired with a “sweet tooth,” it's difficult for many to cut back on sugar. Artificial sweeteners help reduce the amount of sugar in the diet with obvious benefits for general health. It can also make a big difference in your dental health by helping you prevent tooth decay.
One alcohol sugar may even go a step further. In addition to reducing the presence of sugar in the mouth, xylitol (found in chewing gums, candy and breath mints) also seems to reduce bacterial growth by interfering with their ability to ferment the sugar.
If you're considering using an artificial sweetener, get to know them first: some like aspartame aren't suitable for baked goods or cooking, while saccharine or sucralose are. People with a rare genetic condition called phenylketonuria also can't properly process aspartame in the body.
Be sure you also talk to us about artificial sweeteners' impact on oral health, especially the benefits of xylitol for dental care. Used in a wise and informed way, these sugar alternatives can improve both your oral and general health.
If you would like more information on artificial sweeteners impact on dental 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 “Artificial Sweeteners: Satisfying and Protecting your Sweet Tooth.”
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